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Hypnotic Realities

Hypnotic
Realities
The Induction of Clinical Hypnosis
and Forms of Indirect Suggestion
by
Milton H. Erickson Ernest L Rossi Sheila I. Rossi
With a Foreword by Andre M. Weitzenhoffer

IRVINGTON PUBLISHERS, Inc., New York


Copyright © 1976 by Ernest L. Rossi, Ph.D.

All rights reserved. No part of this book may be reproduced in any manner whatever, including information
storage or retrieval, in whole or in part (except for brief quotations in critical articles or reviews), without
written permission from the publisher. For information, write to Irvington Publishers, Inc., 740 Broadway,
New York, New York 10176.
Library of Congress Cataloging in Publication Data
Erickson, Milton H. Hypnotic Realities
Bibliography: p.
1. Hypnotism — Therapeutic use. I. Rossi, Ernest Lawrence, joint author. II. Rossi, Sheila I., joint
author. III. Title
RC495.E72 615'.8512 76-20636
ISBN 0-8290-0112-3 (Formerly ISBN 0-470-15169-2)
Printed in The United States of America 15 14 13 12 11
Reprint Edition 1992
Dedicated to an ever progressing understanding of the total functioning of the individual
person within the self separately and simultaneously in relation to fellow beings and the total
environment.
MHE
Dedicated to those clinicians and researchers who will further explore some of the
approaches to enhancing human potentials described herein.
ELR
Dedicated to all those persons learning through hypnotherapy for personal growth and
professional development.
SIR
ACKNOWLEDGMENTS
We wish gratefully to acknowledge the help we received from the following friends and
colleagues: Roxanne Erickson, Christie Erickson, John Hedenberg, Jack A. Oliver, M.D.,
Robert Pearson, and Kay Thompson.
OVERVIEW CONTENTS
Foreword, by Andre M. Weitzenhoffer / xii

Introduction / 1

One
A Conversational Induction: The Early Learning Set / 5

Two
Indirect Induction by Recapitulation / 27

Three
The Handshake Induction / 83

Four
Mutual Trance Induction / 127

Five
Trance Learning by Association / 149

Six
Facilitating Hypnotic Learning / 205

Seven
Indirectly Conditioned Eye Closure Induction / 233

Eight
Infinite Patterns of Learning: A Two-Year Follow-Up / 281

Nine
Summary / 297

References / 315
ANALYTICAL TABLE OF CONTENTS
Foreword by Andre M. Weitzenhoffer

Introduction

ONE
A Conversational Induction: The Early Learning Set
Observation and Erickson's Basic Approach
The Conscious and Unconscious in Clinical Hypnosis
The Utilization Theory of Hypnotic Suggestion
Truisms Utilizing Mental Mechanisms
Truisms Utilizing Time
Not Doing, Not Knowing
TWO
Indirect Induction by Recapitulation
The "Yes Set"
Psychological Implication
The Bind and Double Bind Question
The Time Bind and Double Bind
The Conscious-Unconscious Double Bind
The Double-Dissociation Double Bind
A General Hypothesis About Evoking Hypnotic Phenomena
Reverse Set Double Bind
The Non Sequitur Double Bind
Contrasting the Therapeutic and Schizogenic Double Bind
Unconscious and Metacommunication
Open-Ended Suggestion
Suggestions Covering All Possibilities of a Class of Responses
Ideomotor Signaling
THREE
The Handshake Induction
Confusion in the Dynamics of Trance Induction
Dynamics of the Handshake Induction
The Handshake Induction
Compound Suggestions
The Paradigms of Acceptance Set, Reinforcement or Symbolic Logic
Compound Statements
The Paradigms of Shock and Creative Moments
Contingent Suggestions and Associational Networks
Multiple Tasks and Serial Suggestions

FOUR
Mutual Trance Induction
The Surprise
The Confusion-Restructuring Approach
Therapeutic Trance as a State of Active Unconscious Learning
FIVE
Trance Learning by Association
The Implied Directive
Questions that Focus, Suggest and Reinforce
Questions for Indirect Trance Induction
The Fragmentary Development of Trance
Depotentiating Conscious Mental Sets: Confusion, Mental Flux, and Creativity
SIX
Facilitating Hypnotic Learning
Displacing and Discharging Resistance
Multiple Levels of Communication: Analogy, Puns, Metaphor, Jokes, Folk Language
The Microdynamics of Suggestion
SEVEN
Indirectly Conditioned Eye Closure Induction
Trance Training and Utilization
The Dynamics of Indirect and Direct Suggestion
Indirect Conditioning of Trance
Voice Dynamics in Trance
Intercontextual Cues and Suggestions
Right- and Left-Hemispheric Functioning in Trance
EIGHT
Infinite Patterns of Learning: A Two-Year Follow-Up
Infinite Possibilities of Creativity, Healing, and Learning
NINE
Summary
The Nature of Therapeutic Trance
Trance Viewed as Inner Directed States
Trance Viewed as a Highly Motivated State
Trance Viewed as Active Unconscious Learning
Trance Viewed as an Altered State of Functioning
The Subjective Experience of Trance
Clinical Approaches to Hypnotic Induction
Orientation to Hypnotic Induction
Approaches to Hypnotic Induction
Depotentiating Habitual Frames of Reference
Indicators of Trance Development
Ratifying Trance
The Forms of Hypnotic Suggestion
The Nature of Hypnotic Suggestion
Indirect Approaches to Hypnotic Suggestion
Structuring an Acceptance Set
Utilizing the Patient's Associative Structure and Mental Skills
The Facilitation of Human Potentials
REFERENCES
Foreword
For the many who never had the opportunity and never will have the opportunity to
attend workshops led by Milton Erickson, this work will serve as an invaluable surrogate.
Psychotherapists, in general, as well as hypnotherapists, will find the work rewarding reading
and study, for Erickson is above all a psychotherapist, and his modus operandi transcends
clinical hypnotism. As for academicians and researchers, I believe they will find enough food
for thought and research here to keep them busy for some time to come.
My first encounter with Milton Erickson was in 1954 or 1955 at a meeting of the Society
for Clinical and Experimental Hypnosis in Chicago. When I met him he was engaged in
conversation with a small group of colleagues in a hotel lobby. I had never seen the man or
even a photograph of him. Yet in a strange way, as it then seemed to me, as I saw him from
some distance out of hearing range, I knew this was Milton Erickson. I have thought back to
this incident a number of times. Conceivably I had heard somewhere that he had had polio
and the fact he leaned on a cane might have been the clue to his identity. I cannot be sure,
but I am inclined to believe the clues were more subtle. In a way, I had encountered Milton a
number of times previously—through his writings which I had studied exhaustively. Through
these, I had begun to appreciate the uniqueness of his person. I believe that some of the
qualities which have made him the individual he is, were communicated to me through these
writings, and that I experienced them more directly as they were manifesting themselves as
he interacted with others.
In the years which followed I was to have other occasions, by far too few to suit me, to
meet with him, watch him demonstrate, watch him doing therapy, and listen to him talk about
hypnotism as well as other matters. More particularly, I had the opportunity to see why, as
the years have gone by, he has grown into a quasi-legendary figure to whom the title of "Mr.
Hypnosis" was once given. I have also had the opportunity to see in action such famed stage
hypnotists of the forties and fifties as Ralph Slater, Franz Polgar, and others, many of whom
billed themselves as "America's Foremost Hypnotist," the "World's Fastest Hypnotist," etc.,
and who extolled their fantastic prowess ad nauseam. Good entertainers, yes. As hypnotists,
however, they came up poor seconds to Milton Erickson, and yet there never was a more
quiet, unassuming man.
It is not surprising then that many professionals have tried to emulate him. None thus far
have ever truly succeeded, although a few have managed to become a fair approximation.
Some of the reasons for this become clear on reading this work. Some of these will still
remain unclear. If the authors have failed to deal with them to the extent that their importance
calls for, it is only because they are not exactly the kind of things one can adequately teach
merely through the written word. Perhaps it is also because they are not teachable and, I
suspect, there is some unwillingness on their part to admit this to themselves and the reader.
As the work makes it most clear, not only what one says to the patient or subject, how
one says it, when one says it, and where one says it are all extremely important factors in the
effective use of hypnotism, particularly in a clinical, therapeutic setting. It also becomes clear
that one must view the hypnotherapeutic interaction in its totality and not piecemeal, and go
even a step further by viewing it within the totality of its utilization. This takes the use of
suggestion, and more broadly, of hypnotism out of the domain of the use of simple magic
formulas and places it within the framework of the science of interactional and
communication networks.
Erickson, however, is not just a master of verbal communication as the work makes
evident. He is equally adept at non-verbal communication, which is one of the aspects to
which the work does not and can not really do justice. This is unfortunate but unavoidable
and certainly not an oversight on the part of the authors. One of the more memorable
demonstrations of his skill at non-verbal communication that he has given in his career was
in Mexico City in 1959 when he hypnotized and demonstrated various hypnotic phenomena
with a subject with whom verbal communication was impossible. He spoke no Spanish and
the subject spoke no English. From beginning to end, communication was carried entirely
non-verbally through pantomime.
I can personally attest to the effectiveness of his non-verbal communications, through an
experience I had with Milton Erickson some 15 or 16 years ago. Here I think I should make it
clear that, to my knowledge, I have never been hypnotized by him, at least formally. A group
of us had met in Philadelphia with Milton, in a special seminar aimed at gaining some
understanding of his modus operandi. One morning I was alone with him sitting at the
breakfast table, facing him somewhat obliquely toward his left. As I recall, I was doing most
of the talking. As I talked, partially absorbed in my thoughts, I became vaguely aware,
peripherally, of Milton making peculiar repetitious gestures with one of his hands.
Momentarily I made nothing of this, then with my awareness increasing, two things happened
in very close sequence. My right hand moved out, spontaneous-like, to pick up the coffee pot
which was on the table and begin to lift it. With this, the realization dawned on me that Milton
wanted coffee. At that point, to use the terminology of this work, my "conscious mind" took
over the action and I completed the act, while realizing now, that Milton's gesturing had,
indeed, clearly spelled out a non-verbal request to have coffee poured into his cup. This sort
of thing, as I learned in time, is one of his favorite ways of teaching or answering a question
about a related matter. It is also his way of subtly testing an individual's suggestibility or
hypnotizability. It is also his way of keeping himself in shape, so to speak. I said, toward the
beginning of this paragraph, that I had never been "formally" hypnotized by Milton Erickson.
True, if by "formal induction," we mean the use of any of the usual classical and semi-
classical techniques described over and over in various texts on hypnotism. For reasons that
will become clear presently, and certainly after reading the present work, I am sure that the
authors would say that I had indeed been hypnotized by Milton at least on that particular
occasion.
There is, of course, much more to effective verbal communication than saying words
according to appropriate syntactical and other linguistic rules, or the introduction of
appropriate non-verbal elements at the correct time and place. In my experiences with Milton
Erickson, I have found that his control of such features as intonation and voice modulation, to
mention only these two aspects, forms an intrinsic part of his approach to hypnotism. One
has to hear and watch him to get the full flavor of his manner of speech. To say that he
speaks gently yet incisively, slowly, calmly, softly, enunciating clearly and carefully each
word, sometimes each syllable, the whole with certain cadence, can only give but a sketchy
flavor of the process. There is, unfortunately, no way for a book to convey to the reader the
kinds of information that would allow him to duplicate these features. However, attention can
be called to this matter so that after studying the book, if the reader finds himself somewhat
less effective than Erickson in spite of his efforts to do everything just so, he will not draw the
wrong conclusions.
Another element which I believe enters into Milton's effectiveness and which, in my
opinion, this work does not sufficiently bring out, is the quiet confidence, and strangely
enough in view of his permissive approach, the authority too, that he exudes. There is a
conviction expressed by his voice and his actions that everything is, or will be, as he says.
Perhaps part of this exuded conviction has its roots in another feature of Erickson's
interaction with his subjects and patients. As one watches him, one becomes very much
aware of his ability to communicate to the subject and patient that he is participating in some
of his experiences and sharing these with him. This is particularly evident when he elicits
hallucinatory phenomena. As one witnesses Milton Erickson tell a subject about a skier "out
there" on a distant snow covered hill which he describes in some detail, or about a rabbit
"right down there at your feet-----and what color is it?" one often has the eerie feeling that he
too
sees the skier, the hill, the snow, and the rabbit. How then, can the subject indeed fail to see
them too? Whether or not Milton actually shares in the subject's subjective experiences, the
impression is verbally and non-verbally communicated to the latter that he does. In my
opinion this is an extremely powerful adjunct in his elicitation of the desired responses.
This is to say then, as a warning to readers who might expect much more than is
reasonable from this work, that I believe there are important elements Milton Erickson brings
to bear in his production and utilization of hypnosis which are not given as much attention as
they deserve. This is not being written in a judgmental manner, an action hardly appropriate
to a foreword. That aspect of the induction and utilization of hypnosis upon which the authors
have chosen to focus is sufficiently complex and central as to justify certain omissions,
particularly of material extremely difficult to deal with in writing.
Indeed, as every modern educator knows, the three major modes of communication,
audio, visual, and written, each contributes in a unique and non-interchangeable way to the
total process of education. What I have just stated merely reflects this fact. As written
communication goes, the present work does a superlative job in elucidating the complexities
of Erickson's approaches to clinical hypnotism. Indeed it accomplishes admirably that which
can only best be done by the written word.
All of this leads me to one last point I would make for all those readers who would aspire
to become another Milton Erickson. The book will teach them some of Milton's "secrets,"
which actually were never secrets at all. It is simply that what he did, and still does, was so
obvious and natural to him that he assumed everyone knew what was going on. Whether
knowing the secrets will be enough is a moot question. Milton did not become "Mr. Hypnosis"
overnight. Many events and experiences have preceded his 50 years and more of
experience with hypnotism. Many other events have filled these fifty years. Which ones have
materially contributed to make the man, the hypnotist, and the clinician that he is? No one
can really tell, even Milton himself. Some can be specified. Of these, some could be
duplicated, some could not, and there are some which one would hardly want to duplicate. A
wide experience with the phenomenology of hypnotism, especially in a naturalistic setting,
extensive and long experience teaching, applying, demonstrating, and experimenting with
hypnotism, all of these must be seen as undoubtedly having played an essential part in
Milton Erickson's spectacular success. These are duplicable. Potentially duplicable by
deliberate innoculation, but hardly the kind of experience anyone would readily undergo, is
being stricken twice with poliomyelitis as Milton Erickson was. Certainly not duplicable is
being born tone deaf and color blind. Erickson attributes much of his heightened sensitivity to
kinesthetic cues, body dynamics, and altered modes of sensory-perceptual functioning to his
life-long struggle with his innate and acquired infirmities. In his study and effort to mitigate
these problems he acquired a personal awareness of altered patterns of functioning that was
channeled into his life-work as healer. Additionally, Erickson has brought to his life-work a
remarkable imagination and creativity, a high degree of sensitivity and intuition, a keen
observing power, a prodigious memory for facts and events, and a particular ability for
organizing what he experiences on a moment to moment basis. There is little here that can
be duplicated on demand.
If one is not likely to ever be another Milton Erickson, one can at least learn something
about his modus operandi and utilize it as completely as possible within one's own limitations
and in terms of one's own personal assets. If this work does nothing more than help the
reader accomplish this, it will have attained its purpose.
In approaching this work the reader should keep in mind that it is the product of
pragmatists, and that it is specifically about therapeutic or clinical hypnotism, and neither
about theoretical or experimental hypnotism. The reader might as well know from the outset
that he will not find in this book any well defined and worked out theory, nor any solid
scientific documentation of many stated facts. Quite clearly, the authors espouse a certain
theoretical position with regard to the nature of hypnosis, of hypnotic phenomena, of
suggestion, and of suggested behavior. One may or may not agree with them, and many
alternative explanations will come to the reader's mind as he follows the authors'
explanations of what takes place when Erickson makes a certain intervention or takes a
certain step. However, to get the most out of this work, one needs to keep in mind that its
focus is not so much upon developing a scientific theory as it is upon elucidating how Milton
Erickson obtains the kinds of results that he does; results which most would agree involve
behavior which may be labeled as being "suggested" and/or being "hypnotic." From a
practical, pragmatic standpoint it is relatively immaterial whether these elicited behaviors are
"veridical," "role-playing," "a product of cognitive restructuring," involve some sort of
"dissociative process," or are the consequences of a "shaping" process, and so on.
Eventually, the "true" scientist wants to know what is what. This the authors have well
recognized, often pointing out areas for investigation and suggesting experiments which
could be made. But for the busy clinician and for the long suffering patient it is results, and
quick ones at that, which count. Efficacity is the issue. For this reason effective
hypnotherapists, which the three authors are, do not limit themselves to hypnotic procedures
per se. On the contrary, as is evident from this book, and even more so from other writings of
Erickson and of Rossi, effective hypnotherapy constantly interweaves the utilization of
hypnotic and non-hypnotic behavioral processes. To take just one tiny example, the use of
the "double-bind," be it as understood by Bateson, or in the special sense that the authors
use it, is not a hypnotic technique or approach per se, nor does it involve a hypnotic or
suggestion process, but it can be used as a specific tool to induce hypnosis and/or as a tool
to elicit further behaviors from a hypnotized individual.
Although theory is neither the strength nor the focus of this book, a very definite
theoretical position is reflected by Erickson's modus operandi, or at least guides it. It has
been traditional, and this is still widely done, to view hypnotic behavior as behavior elicited by
"suggestions" given while the subject is in a state of "hypnosis." However, even prior to
Bernheim, and earlier, it has also been widely recognized that suggestions leading to the sort
of behaviors exhibited by hypnotized individuals can also be effectively used in the absence
of any induction of hypnosis. That is, they can be effective with persons who have
presumably not been hypnotized. One interpretation of this observation, to which a small
number of modern investigators have ascribed, is that hypnosis is not only unnecessary for
the production of hypnotic behavior, but is also actually an unnecessary concept. This
interpretation leads to the position there is no hypnosis as a state. However, one alternative
to this position, and this is the one taken by the authors, is that all bonafide responses to
suggestions are associated, ipso facto, with a hypnotic or trance state. From this standpoint
there is no longer any distinction between "waking" and "hypnotic" suggestions, or if one
prefers, between extra and intrahypnotic suggestions. To respond adequately to a
suggestion is to be hypnotized. To put it a little differently, according to the authors, one
cannot respond adequately to a suggestion without first, or at the same time, developing a
hypnotic trance. This particular view of the situation comes about in a two-fold way: For the
authors, if a response is to be an adequate response to a suggestion, it must be mediated by
a different aspect of the mind than so-called conscious behavior. Thus they distinguish
between behavior executed by the subject's "unconscious" and "conscious" mind. Normally,
the conscious dominates the unconscious. The traditional inductions of hypnosis are nothing
more or less than a freeing of the unconscious from conscious dominance, which is what
they see as also momentarily existing any time an individual responds adequately to a
suggestion. For them to function completely at the unconscious level is to be in a trance or
hypnotic state, too. Any shift from conscious to unconscious functioning is a passage from a
non-trance to a trance state ("waking" to "hypnotic state"). Although this will most likely be
clear to many readers, it may be well to make the point here that the authors' conception of
the "unconscious" is definitely not the one held by Freud. Morton Prince's "subconscious" is
perhaps the closest to it. In any case it is an intelligent, complex level of mental functioning
which appears to retain certain ego functions possessed by the conscious mind, while
relinquishing, or not being affected by, some of the other functions usually associated with
the ego.
One consequence of the above view of suggestion and hypnotism is that the notion of
hypnosis as a state of hypersuggestibility becomes meaningless. To be suggestible is to be
hypnotized. These are merely alternative ways of speaking of the same thing. It follows from
this then, that it is also meaningless to speak of testing an individual's waking or non-
hypnotic suggestibility, as a predictor of his hypnotizability. Finally, a formal induction of
hypnosis, when it is successful, might be viewed in this framework as nothing more than an
obtrusive technique which brings about a shift in degree of increased unconscious
participation in a step-like fashion. The real impact of viewing hypnotic and suggested
behavior as the authors do, however, is to be found in the central topic of this work. How to
facilitate, activate, cultivate, and, to some extent, utilize unconscious levels of functioning.
This is what this book is about.
I have spoken at great length about Milton Erickson, and justifiably so, since this is a
book about his approach to the therapeutic utilization of hypnotism. Still, this work is a joint
effort and, had it not been for another of the authors, in particular, Ernest L. Rossi, it would
never have seen the light of day. Rossi has done much more than record and report that
which Erickson does and says. He has spent an enormous amount of time and effort getting
him to explicate what has been so clear to Milton but so obscure to everyone else. Having
done so, Rossi has proceeded to unravel, sift, analyze, translate, organize, and finally
integrate what must at first have seemed to him to be a bewildering collection of data. This
has been no small task, as I can attest to from my own unsuccessful past efforts to do
something similar on a much smaller scale. Furthermore, Rossi has succeeded, I believe, in
giving us an opportunity to see in a unique way, what Erickson does through the latter's very
own eyes. Ernest Rossi's particular contribution does not stop there, however, and is to be
further found in his compilation of interesting, useful, and thought provoking exercises,
questions, commentaries and suggestions for research.
Finally, I believe that students of Erickson will find in this book answers to questions they
wish they could have asked of him, but never did or could, and even more so, answers they
sought but never got.
Andre M. Weitzenhoffer Oklahoma City
Hypnotic Realities
Introduction
This volume is the record of a unique demonstration by Milton H. Erickson of the art of
inducing clinical hypnosis and the indirect forms of hypnotic suggestion. It is the record of a
process of training and discovery. Initially, the senior author, Erickson, was involved in
training the junior authors, the Rossies, in clinical hypnosis. As this training progressed, it
became an analysis of the basic aspects of Erickson's work. Since the Rossies were
beginners in the field, Erickson had to introduce and demonstrate the basic principles of
clinical hypnosis in a manner that makes this volume suitable as an introductory text to the
field. Since Erickson is such a creative innovator, however, much of the material will be of
great interest to all psychotherapists, whatever their level of training or field of specialization.
It will be seen on the following pages that clinical hypnosis and therapeutic trance (using
these terms synonymously) are carefully planned extensions of some everyday processes of
normal living. Without quite realizing it, we all experience the "common everyday trance"
wherein we are absorbed in a moment of inner reverie or preoccupation. During such periods
we go about our daily routine somewhat automatically; much of our attention is actually
focused inward as we experience ourselves a bit more deeply and possibly gain a fresh
perspective or even solve a problem. Similarly, in the clinical utilization of trance we can be
more receptive to our own inner experience and unrealized potentials in ways that are most
surprising. With the help of a therapist's suggestions, these potentials may be explored and
further developed.
The hypnotherapist shares many views in common with other well-trained
psychotherapists: an understanding of the dynamics of unconscious processes in behavior;
an appreciation of the significance of emotional and experiential learning as well as
intellectual knowing; a high regard for the unique life experience of each individual; and so
on. Hypnotherapists are different in practice, however, in that they are more specialized in
the deliberate utilization of these processes within individuals to help them achieve their own
therapeutic goals in their own unique way. In these pages Erickson demonstrates a myriad of
approaches by which psychotherapists of all persuasions can facilitate psychological
development with or without the formal induction of trance. He believes that trance itself is a
different experience for every person; indeed, clinical trance may be understood as a free
period in which individuality can flourish. From this point of view one comes to understand
Erickson's work as an active approach to the basic endeavor of all psychotherapy: helping
individuals outgrow learned limitations so that inner potentials can be realized to achieve
therapeutic goals.

THE FORM OF THIS VOLUME


Each chapter begins with a carefully transcribed record of Erickson's induction of clinical
hypnosis and his work with a subject along with a commentary to elucidate his procedures.
His nonverbal behavior (gestures, pantomime, etc.) is described in parentheses. In these
records there is some repetition of the procedures utilized, the questions asked, and the
issues discussed. This repetition came about naturally because Erickson was engaged in
training the Rossies in hypnotherapy. The Ros-sies frequently had to ask the same questions
over and over to be sure they understood what Erickson was trying to convey. The repetition
of similar themes in different contexts allows the reader to explore the significant features of
Erickson's work and how he utilizes them in the contingencies of daily practice.
The induction section of each session is an extremely careful transcription of Erickson's
exact words in boldface type. When he paused momentarily, his words are set off by a new
line of type or by extra space between his words or phrases. When he paused for more than
20 or 30 seconds, it was indicated by the word "pause" in parentheses. Since this material
was recorded when Erickson was 72 years old on an ordinary cassette machine, there were
a few occasions when some words were lost. This was carefully indicated with ellipses (. . .).
The induction section thus provides the reader with the empirical raw data of Erickson's work
unadulterated by anyone else's preconceptions. Erickson carefully read and approved of
these transcriptions of his work. The induction section could thus serve as an objective
record that other research workers could analyze in future studies of Erickson's approach.
The commentary sections, indented in ordinary type, are a discussion between Erickson
(E) and Ernest Rossi (R) wherein Erickson explains his work with the subjects (S). The
content of these commentaries was determined in equal parts by what Erickson felt to be the
relevant material to be taught and by what Rossi felt he needed to ask in order to
understand. These discussions were complex and sometimes drifted far from the issues at
hand. For the practical purposes of publication, some of these discussions have been edited
or paraphrased to make their meaning clear.
While some of these commentaries are thus slanted a bit through the lenses of Rossi's
understanding and needs, they were also carefully read and sometimes modified by Erickson to
emphasize a point here or clarify an issue there.
Each chapter ends with a number of sections by Ernest Rossi to clarify and elaborate on
the relevant issues of Erickson's work just illustrated. At times Rossi attempts to analyze
Erickson's clinical approach in order to uncover some of the basic variables that could be
isolated and tested by future experimental work. These sections may be understood as an
effort to build a bridge between the clinical art of Erickson's hypnotherapy and — the
systematic efforts of the science of psychology to understand human behavior.
In studying this volume readers may do best by first reading the induction sections that
are the "purest" indications of Erickson's work. Readers can then draw their own conclusions
and ask their own questions about the work before progressing to the commentary sections.
They can then determine for themselves the adequacy of the explications of the inductions.
Readers may then write their own analyses of the relevant variables and perhaps test them,
adding to the general knowledge.
At the end of each chapter or section where new material has been introduced, a number of
graduated exercises are offered as a guide to aid hypnotherapists in developing their own skills in
the clinical arts of observation, hypnotic induction, and the formulation of indirect suggestions.
Many of these exercises will be of value to the general psychotherapist with or without the formal
induction of clinical hypnosis.
This volume thus can serve as a heuristic, stimulating practicing psychotherapists to improve their
own education and training. It also provides researchers with a clinical source of hypothesis about
hypnotic phenomena and hypnotherapy that can be tested in a more controlled experimental
fashion.
ONE

A Conversational Induction:
The Early Learning Set
Dr. S was a psychologist and mother who was available to cooperate in a unique
demonstration to ascertain if it was possible to train a professional person to become a
hypnotherapist by having her learn by experiencing hypnosis personally. Dr. S had no
experience with hypnosis apart from one demonstration where she experienced a short
induction. This served to arouse her interest in the field, and she agreed to being tape-
recorded in return for the free training she would receive.
Erickson initiates the process in this first session with what we may call the "Early
Learning Set" induction. He simply requests that S focus on a spot while he talks with her.
His approach is casual, gentle, warm, and friendly. Erickson simply talks about kindergarten
and learning, imagery and comfort, the abilities of the unconscious and some alterations of
the blink reflex. This is an example of conversational induction so innocuous and indirect that
it is often difficult to recognize that trance is being induced. The impatient tyro waits in vain
for him to begin the H*Y*P*N*O*S*I*S. Where are the mysterious manipulations that will take
possession of the subject's mind and body? Where are the frenzy, prostration, stupor, and
bizarre gesticulations that ancient medical lithographs have illustrated as possession and
trance?
Modern hypnotherapy is quite different from the popular conception of hypnosis as a
mysterious drama. Therapists are not showmen. They are, however, highly skilled in
observation and can recognize even minor variations in behavior that provide important clues
to the patient's interests and abilities. These clues are then utilized to help guide the patient
into those interesting states of altered awareness that are generally called trance." Therapy
then proceeds by "taking the learnings that the Person already has and applying them in
other ways." Erickson is wary about suggesting or adding anything new to the patient; he
would rather facilitate the patient's ability to creatively utilize and develop what he already
has.
In this first session Erickson introduces a number of themes that will be repeated in ever-
widening contexts in the later sessions: focusing the patient inward, freeing unconscious
(autonomous) processes from the limitations of a patient's conscious sets, some principles
and forms of indirect suggestion, and the ethics of trance and hypnotherapy. The beginning
student in hypnotherapy often wants to learn everything all at once. That approach cannot
really succeed. An understanding of the material develops naturally over time as Erickson
goes over the fundamentals again and again in successive sessions. Frequently, the
significance of the material in the early sessions is not entirely understood until later.
Because of this, serious students may find themselves returning to restudy each session
many times before it will be well understood.

Observation
E: Look at the far upper corner of that picture.
Now you (R) watch her face.
The far upper corner of that picture.
Now I'm going to talk to you.
(Pause)
E: So often the therapist does not even look at the patient's face. Yet changes in facial
expression, muscle tonus throughout the body, and the breathing tell you how much of
the patient's attention has been directed to the problem at hand. No sense in trying to
work with a patient who's making restless movements.
R: The quieter the patient, the more he's directing energy to what is being said.
E: Yes! And you also notice whether the patient can be distracted from the therapy.
Can the patient be disturbed by a bus outside or a siren? The less disturbed they are
by such outer distractions, the more focused is their energy on therapy. You can only
tell these things by carefully watching the patient.

Early Learning Set


When you first went to kindergarten, grade school,
this matter of learning letters and numerals seemed to be a big insurmountable task.
E: Now here you are merely taking the learnings that the person already has and
applying them in other ways. But you're not creating anything new.
R: You're utilizing a learning set that already exists in the patient. It is a learning set
that you're evoking by this particular induction.
E: Yes.

Truisms as the Basic Form of Hypnotic Suggestion


To recognize the letter A
to tell a Q from an O was very, very difficult.
And then too, script and print were so different.
But you learned to form a mental image of some kind.
You didn't know it at the time, but it was a permanent mental image.
R: You are using a series of very obvious truths, truisms, as suggestions here. As you
speak of these early experiences, your words tend to evoke early memories and may
facilitate an actual age regression in some subjects.
E: Yes. Suggestions are always given in a form that the patient can accept easily.
Suggestions are statements that the patient cannot possibly argue with.

Internal Imagery
And later on in grammar school you formed other mental images of words or pictures
of sentences.
You developed more and more mental images without knowing
you were developing mental images.
And you can recall all those images.
(Pause)
E: The average hypnotherapist says, "Look at this spot," and tries to focus the patient's
attention to the spot. But it is easier to deal with the images the person has in his mind.
There's a large variety of images in his mind, and he can slip easily from one to another
without leaving the situation.
R: So internal imagery is therefore much more effective in holding attention.
E: Some external thing has no real value to them, but the images they have within are
of value. Furthermore, you're only talking about what did occur in their past. It is their
past and I'm not forcing anything on them. They did learn the alphabet, their numerals.
They did learn many, many images. They can be pleased and select any image they
want.
R: Far from arousing resistance, you're actually on their side in sympathy with them.
You sympathize with their difficulty in learning, so you align yourself with the patient's
difficulties.
E: That's right. And you know from your own experience it was hard.
R: With all that early accomplishment you're tapping, you also arouse their motivation
for their current work in hypnosis.

Relations of Consciousness and Unconscious


Now you can go anywhere you wish, and transport yourself to any situation.
You can feel water
you may want to swim in it.
(Pause)
You can do anything you want.
E: This sounds like a great deal of freedom, but note I have given the suggestion to
"transport" your consciousness to another situation. It can be any place you wish. It will
probably be associated with water and you can do anything you want, but your
consciousness need not be focused here in the therapy room.

Unconscious Functioning:
Allowing the Conscious Mind to Withdraw
You don't even have to listen to my voice
because your unconscious will hear it.
Your unconscious can try anything it wishes.
But your conscious mind isn't going to do anything of importance.
E: The patient is not paying attention to me with his conscious mind, but the
unconscious will pick up what I'm saying.
R: So your method gets directly to the unconscious without the intervention and
distortion of consciousness.
E: Sometimes patients will later say, "I wish you had let me stay in the water or the
garden longer."
R: So being in an "inner garden" is a way you have of holding their conscious attention.
You're having their conscious attention focused on an internal image just as watching a
spot focuses their attention on an outer image. But being absorbed in an internal image
is much more effective for focusing attention.
E: Much more effective!
R: And while they are so absorbed, their consciousness is distracted so you can make
suggestions directly to their unconscious.
E: They are far more interested in the conscious things. They are not paying attention
to what I say consciously. They are paying attention unconsciously, so there is no
interference from consciousness.
R: That's the important use of images: they bind a person's conscious attention while
you make other (e.g., therapeutic) suggestions directly to their unconscious.
E: And it is very important for a person to know their unconscious is smarter than they
are. There is a greater wealth of stored material in the unconscious. We know the
unconscious can do things, and it's important to assure your patient that it can. They
have to be willing to let their unconscious do things and not depend so much on their
conscious mind. This is a great aid to their functioning. So you build your technique
around instructions that allow their conscious mind to withdraw from the task and leave
it all up to the unconscious.
R: You don't want them to have conscious control but to allow their unconscious to
function smoothly by itself.
E: And then the results of that unconscious functioning can become conscious. But first
they have to get beyond their conscious understanding of what is possible.

Eyelid Flutter:
Limiting Internal Responses
You will notice that your conscious mind is somewhat concerned since it keeps
fluttering your eyelids.
E: Here I limited the fluttering to the eyelids rather than letting her generalize it into
believing her whole system was fluttering or uncertain.
R. That slight, rapid, vibratory flutter of the eyelids during the initial phase of an
induction is frequently taken as an indication of beginning trance.

Proving an Altered State


But you altered your rate of breathing.
You've altered your pulse.
You've altered your blood pressure.
And without knowing it, you're demonstrating the immobility that a hypnotic subject
can show.
E: They don't know, but when you tell them they have altered their functioning, they can
become aware of it. Their functioning is already altered so they cannot resist or deny it.
They have their inner proof.
R: They have proof of an altered state. You inform the patient of these things to prove
the hypnotic state rather than using a challenge.
E: That's right. I don't like to use the lack of the swallow reflex as a challenge because
they tend to test that one. I'd rather use things they cannot test.
R: Because patients tend to swallow less during trance, some therapists have used it
as a test of trance depth. They will "challenge" patients by telling them they cannot
swallow. During the initial stages of trance training, however, such a challenge might
actually arouse some patients.

Downgrading Distractions
There is nothing really important
except the activity of your unconscious mind,
E: That down grades traffic sounds or any other outside distractions without
emphasizing that there are outside distractions. They can then apply this downgrading
to whatever irrelevant stimuli that might be intruding.
R: You don't project your distractions on the patient and you don't even suggest there
are distractions. But if there are distractions this phrase helps the person to downgrade
them.

Implication and Illusory Freedom in the Dynamics of Suggestion


and that can be whatever your unconscious mind desires.
E: This is an example of what Kubie calls "illusory freedom." The person has a very
great subjective feeling of freedom of choice, but actually I hold my subject to the task
at hand through subtle directives and implications. For example, in the above I did say,
"You can go anywhere you wish," but then I did define a place: water.
R: So the art of giving suggestions is to give careful direction, but you let the person
have a certain illusion of freedom within the framework you have constructed.
E: When I earlier said, "Your unconscious can try anything it wishes," it sounds as if I
were giving freedom, but actually that word "try" implies the opposite. The word "try"
implies a block. You use the word "try" for your own purpose when you want to imply a
block.
R: Use of the word "try" at that point actually blocked or tied up the unconscious until it
received further directives from you.
E: Then when I say, "Your conscious isn't going to do anything of importance," it
implies that your unconscious will do something of importance.
R: And the unconscious cannot do anything it wishes because you have already tied it
up. In sum, this implies that the unconscious is going to do something important, and
it's going to be what you suggest.

Not Knowing, Not Doing


Now physical comfort exists,
but you don't even need to pay attention
to your relaxation and comfort.
E: Notice how I emphasize "you don't even need." Patients drag along too much, so
you emphasize all they don't need so energy can be focused on the task at hand.
R: This reinforces your earlier remark, "You don't even have to listen to my voice." It
facilitates trance induction when the patient does not have to know or do anything.

Implication
I can tell your unconscious mind
that you are an excellent hypnotic subject,
and whenever you need to or want to,
your unconscious mind will allow you to use it.
E: "I can tell your unconscious" implies 1 don't have to convince your conscious.
R: In other words, every sentence has implications, and it is in these implications that
the important message is given.
E: Yes!

Implication and Time


And it can take time its own time
letting you go into a trance
helping you to understand anything reasonable
E: You can take your time, but you are going to do it. That's the important implication.
And they don't know how much time, so they have to rely on you.

Rapport
I can speak to you or anyone else I choose,
but only when I speak to you is it necessary for you to listen.
I can direct my voice elsewhere
and you will know I am not speaking to you
so you will not need to pay any attention.
E: Here I'm setting up a lot of freedom for myself in future work.
R: You are also giving suggestions for rapport wherein she will pay attention only when
you are addressing her.

Signs of Trance
Dr. Rossi I think you see a lot of behavior of great interest.
The alteration of the blink reflex.
The alteration in facial muscles, the total immobility.
R: The slowing of the blink reflex before the final closing of the eyes and the relaxation
of the facial muscles so the face has a smoother or "ironed out" expression are typical
indications of trance.

Ethical Principle
R: Would you like to go on now and demonstrate more phenomena?
E: I might like to, but I did not discuss it with her consciously. Therefore if I go on I
must first wake her up and ask her permission. The unconscious always protects the
conscious.
Would you like to awaken now?
E: 1 cannot ask for permission to do something in trance while she is in trance. Asking
for permission belongs to the normal state of awareness, and we must therefore ask
while she is awake. You must be careful to protect the integrity of the personality and
not exploit the trance state.
R: That would break trust and only arouse the so-called resistance.

Body Orientation on Awakening from Trance


[S opens her eyes and stretches a bit.]
Notice the body reorientation when she came back. Now, is there anything you want to
tell us?
R. This reorientation to the body at the termination is another cue the therapist can use
to recognize the patient has been in a trance. The stretching, blinking, shifting of body
posture, yawning, wetting of lips, smoothing of hair, touching various parts of the body,
etc., are all indications that the patient is reorienting from the trance to the awake state.

Perceptual Alterations:
Eye-Fogging Phenomenon
S: Oh I enjoyed it, it was very peaceful. I was watching the point up there and it got
foggy.
R: I see, a perceptual alteration.
R: This report of a fogging of the visual field is another fairly common indication of
trance development. Others may report blurring, tunnel vision, alterations in the color of
the background or the size and shape of things, etc.

Relaxation and Inner Absorption


S: I tried to listen in the beginning but then I went off onto my own thing. It would have
been tedious to listen to you Dr. Erickson. I just felt like relaxing.
[After the tape recorder was turned off and the session had formally ended, S
mentions her experience of "drifting" in the early stages of trance induction.]
R: Her relaxation and inner absorption to the point where she no longer made an effort
to listen to you are further indications of trance. She was also following your earlier
suggestion that she need not listen to your voice consciously because her unconscious
could pick up what you were saying. She obviously was responding on an unconscious
level since she did end her inner absorption when you told her to awaken.

OBSERVATION AND ERICKSON'S BASIC APPROACH


Observation is the most important aspect of the early training of the hypnotherapist. For
Erickson this training began in youth and has continued through his life. Observation of the
invariants and correlations in human behavior is the sine qua non, the stock-in-trade, of the
creative hypnotherapist. The anecdotes and stories that Erickson tells on the following pages
reveal him to be an acute observer of the regularities of human behavior. Erickson enjoys
humor, and all of this original jokes are based on a sound knowledge of what people would
do in a given situation.
As a child walking through the Wisconsin snow to school, for example, he delighted in
leaving home early in the morning so he could set a crooked path on the straight roads of the
flat plains and later observe how everyone who came after him followed his exact footsteps.
People did not follow the straight road they knew was there; they apparently found it easier to
follow the crooked path he made until he began to straighten it by cutting out some of the
crooked loops on his later walks to school.
It is the regularities of behavior that are of great significance. These regularities are tools
he uses to shape hypnotic phenomenon and behavior. Given a certain stimulus, it is useful
for him to know that a certain response will follow. Or, if he can evoke one piece of behavior,
it is important for him to know that another piece of behavior is closely related to it and is
likely to occur. Thus, he can use one stimulus to evoke a certain response and then use that
response to evoke, by association, another specific response.
The situation is subjectively experienced as hypnotic when these responses appear to
take place without conscious intention because patients are not aware of these predictable
associations within themselves. Patients do not know all of the possibilities within their own
behavioral repertory. Consequently, when they experience something that they could not
have predicted (although the therapist can, because of his knowledge of the patients'
behavioral associations), they assume the hypnotherapist somehow caused it. The
hypnotherapist did arrange the behavioral situation so that a certain response by the patient
would naturally follow. But the hypnotherapist was able to "cause" the response only by
knowing how to utilize preexisting structures within the patient's behavioral matrix.
From this it follows that the more therapists know about the lawfulness of behavior, the more
adequately will they be able to evoke desired responses in any specific situation. The more
therapists are able to observe about the specific regularities of the individual patients, the
more will they be able to facilitate therapeutic responses in those individuals.

Exercises in Observation
1. Look for and carefully study regularities in patients' behavior. These regularities can
range from the mannerisms and rituals of saying "Hello" and adjusting themselves in the first
minute or two to the therapy session to the habitual patterns in their associative structure
when they talk about "problems." To what degree can you observe how a patient's problem is
defined by a "closed circuit of associations," an habitual and invariant pattern of associations
that the patient does not know how to break out of? What intervention can you make to help
the patient break out? (Rossi, 1968, 1972a, 1973a).
2. Observe to what degree various patients are open and available to change and
capable of following you and to what degree they are fixed, closed, unavailable for change—
and actually expect you to follow them. Erickson looks for "response attentiveness" (the
degree to which a person is absorbed in what another is saying) in assessing the degree to
which a person would be a capable hypnotic subject. The more response attentiveness, the
better the subject. We might therefore assume that the more a patient is open to therapist
direction and the greater his capacity to be absorbed in what the therapist is saying, the
greater his capacity as a hypnotic subject.
This requires that therapists focus on the "process" aspect as well as the "content," of
their relation to their patients' behavior. Therapists who would become adept in hypnotherapy
train themselves to observe the dynamics of "availability" and "following" in the transference-
countertransference relation. The greater the openness and availability, the greater the
following and capacity for hypnotic response. What helps a particular patient become more
open and available to therapists? What can therapists do to make themselves more open
and available to each patient?
We note that availability and following comprise a two-way street. The more sensitively
therapists are capable of responding to patients' needs, emotions, and world view, the more
will patients learn to be open and available to following the therapeutic suggestions. The
more adequately therapists relate to their patients in the I-thou experience, the more relevant
and therefore acceptable will their understanding and suggestions be.
3. The practical art of trance induction requires that therapists learn to observe behavior
and tie suggestions to it. What changes are occurring in facial behavior? Does one observe a
preliminary quiver of the eyelids? If so, then it can be suggested that the patient will soon
blink his eyes. Is the blink reflex slowing? If so, the therapist can note it and suggest it will
soon get slower until the lids finally close. When it is observed that the patient has just
exhaled, that is the precise moment to suggest he take a deep breath. When it is observed
that body movements are slowing, it can be suggested that the patient is becoming immobile
and will soon be completely quiet and comfortable. Therapists can become so conversant
with suggestions that they can automatically associate the patient's manifest behavior with
further suggestions. They gradually develop a flow of language that permits them to speak
and reflect while carefully studying the patient's behavior to determine what is to be
suggested next. One can practice such careful observation in many situations of everyday
life. People in audiences and fellow passengers on a bus, plane, or train will be in a range of
states from tenseness and alertness to trance. Learn to recognize the behavioral correlates
of such states. In early practice inductions one can learn the art of observing behavior,
commenting on it, and adding suggestions that will anticipate and further develop the
behavior. In the sections that follow we will gradually introduce the various forms of indirect
hypnotic suggestion that can be learned as one gains more experience.

THE CONSCIOUS AND UNCONSCIOUS IN CLINICAL


HYPNOSIS
Erickson emphasizes certain aspects of the relations between the conscious and
unconscious and the many ways of utilizing them for therapeutic purposes in his work with
clinical hypnosis. This is a major theme that is introduced in this first commentary and will be
discussed further in practically all the following sessions. We believe that consciousness,
programmed by the typical attitudes and beliefs of modern rationalistic man, is grievously
limited. It has been estimated that, at best, most people do not utilize more than l0 percent of
their mental capacity. Most of us simply do not know how to utilize our individual capacities.
Our educational system has taught us how to measure up to certain external criteria of
learning only. We learn our A B C's, how to read and write, and similar skills. The adequacy of
our learning is measured by our scores on standardized achievement tests rather than the degree
to which we utilize our own unique neural circuits for our individual goals. Our educational system
as yet has little or no means of training and measuring the individual's ability to utilize his own
unique behavioral matrix and associative processes even though this internal ability is of the
essence in creativity and personality development.
Consciousness is thus programmed to meet outer consensual standards of achievement,
while all that is unique within the individual remains in abeyance. That is, most of our
individuality remains unconscious and unknown. Erickson can say, "It is very important for
people to know their unconscious is smarter than they are. There is a greater wealth of
stored material in the unconscious."
Patients have problems because their conscious programming has too severely limited their
capacities. The solution is to help them break through the limitations of their conscious attitudes
to free their unconscious potential for problem solving.
Again and again we will find that Erickson's approaches to inducing trance and problem
solving are usually directed toward circumventing the rigid and learned limitations of the
patient's conscious and habitual attitudes. We will later demonstrate and discuss means of
"depotentiating conscious sets," "coping with consciousness," and the like. All these phrases
denote the same effort to free individuals from their learned limitations. As Erickson so clearly
states, "You build your technique around instructions that allow their conscious mind to
withdraw from the task, and leave it all up to the unconscious."
To implement this goal of freeing unconscious potentials from the limitations of
consciousness, Erickson has pioneered the indirect approaches to hypnotic suggestion.
These approaches are in marked contrast to most previous and current work in hypnosis,
where direct suggestions are still considered to be the major therapeutic modality. The
following sessions and commentaries will be a gradual introduction to these indirect
approaches. So multifaceted and vast are the possibilities of these indirect approaches that
Erickson has never been able to organize them into a comprehensive system; in fact, he
does not always understand why and how they work. Indirect approaches are thus still a
virgin field, a terra incognita, that some readers will hopefully explore and extend further in
their own research and therapeutic practice.

THE UTILIZATION THEORY OF HYPNOTIC SUGGESTION


We recently outlined the utilization theory of hypnotic suggestion as follows (F.rickson
and Rossi, 1975):
Trance is a special state that intensifies the therapeutic relationship and focuses the patients attention
on a few inner realities; trance does not insure the acceptance of suggestions. Erickson depends upon
certain communication devices . . . to evoke, mobilize and move a patient's associative processes and
mental skills in certain directions to sometimes achieve certain therapeutic goals. He believes that
hypnotic suggestion is actually this process of evoking and utilizing a patient's own mental processes
in ways that are outside his usual range of intentional or voluntary control.
The effective hypnotherapist learns to use words, intonations, gestures, and other things
that evoke the patient's own mental mechanisms and behavioral processes. Hypnotic
suggestion is not a kind of verbal magic that can be imposed on patients to make them do
anything. Hypnotic suggestions are effective only to the degree that they can activate, block,
or alter the functioning of natural mental mechanisms and associations already existing
within the patient. Erickson likes to emphasize that hypnotic suggestion can evoke and utilize
potentials that already exist within patients, but it cannot impose something totally alien.
Hypersuggestibility is not necessarily a characteristic of therapeutic trance as he uses it.
In his first published paper on hypnosis (1932) Erickson found that "hypersuggestibility
was not noticed" as a necessary characteristic of trance. His work with 300 subjects involved
in several thousand trances led him to this conclusion:
Far from making them hypersuggestible, it was found necessary to deal very gingerly with them to
keep from losing their cooperation and it was often felt that they developed a compensatory
negativism toward the hypnotist to offset any increased suggestibility. Subjects trained to go into a
deep trance instantly at the snap of a finger would successfully resist when unwilling or more
interested in other projects. ... In brief, it seems probable that if there is a development of increased
suggestibility, it is negligible in extent.
Erickson was not alone in this finding. In his review of the history of hypnosis
Weitzenhoffer (1961, 1963, 1971) has pointed out that the earliest investigators (such as
Bertrand, Despine, and Braid) did not view suggestibility as the essential feature of trance. It
was Liebeault, and especially Bernheim (1895), who paved the way for viewing
hypersuggestibility as a necessary condition for speaking of hypnosis or trance. This may
have been accepted by modern experimentally oriented investigators (Hull, 1933; Hilgard,
1965) because it lent itself easily to the development of "hypnotic susceptibility scales," which
were thought necessary for the quantitative study of hypnotic phenomena. Weitzenhoffer,
however, has maintained the necessity of exploring the concepts of trance and suggestibility
as separate issues.
For Erickson, trance and hypnotic suggestion are separate phenomena that may or may
not be associated in any given individual at any given moment. Because of this Erickson
(1952) has emphasized the difference between "trance induction versus trance utilization." In
his early work he found it necessary to spend "four to eight or even more hours in inducing
trances and in training the subjects to function adequately, before attempting hypnotic
experimentation or therapy." The eight sessions of Erickson's work with Dr. S in this volume
are thus a typical example of training a subject to experience trance. It will be seen that
trance is a highly individualized process that can be experienced very differently even by the
same person on separate occasions. For the therapeutic purposes of clinical hypnosis,
however, we will focus our interest on exploring and facilitating only one particular aspect of
trance. We are interested in that therapeutic aspect of trance wherein the limitations of one's
usual conscious sets and belief systems are temporarily altered so that one can be receptive
to an experience of other patterns of association and modes of mental functioning.
Erickson views the separate issue of hypnotic suggestion as a problem in communication
and utilization. To facilitate suggestion one must learn how to communicate more effectively.
A major objective of this volume is to isolate the hypnotic forms of communication Erickson
uses to facilitate suggestion. These hypnotic forms are communication devices that facilitate
the evocation and utilization of the patient's own associations, potentials, and natural mental
mechanisms in ways that are usually experienced as involuntary by the patient. Ordinary,
everyday, nonhypnotic suggestions are acted upon because we have evaluated them with
our usual conscious attitudes and found them to be an acceptable guide for our behavior,
and we carry them out in a voluntary manner. Hypnotic suggestion, by contrast, is different in
that the patient is surprised to find that experience and behavior are altered in a seemingly
autonomous manner; experience seems to be outside one's usual sense of control and self-
direction. A successful clinical hypnotic experience, then, is one in which trance alters
habitual attitudes and modes of functioning so that carefully formulated hypnotic suggestions
can evoke and utilize other patterns of associations and potentials within the patient to
implement certain therapeutic goals.
The utilization approach to trance induction (Erickson, 1958, 1959) and the utilization of
the patient's presenting behavior and symptoms as an integral part of therapy (Erickson,
1955, 1965b) are among Erickson's original contributions to the field of clinical hypnosis. This
utilization approach, wherein each patient's individuality is carefully studied, facilitated, and
utilized, is one of the ways "clinical" hypnosis is different from the standardized approaches
of experimental and research hypnosis as it is usually conducted in the laboratory. It is in the
clinician's ability to evaluate and utilize patients' uniqueness together with the exigencies of
their ever-changing real-life situation that the most striking hypnotic and therapeutic results
are often achieved. The utilization approaches achieve their results precisely because they
activate and further develop what is already within the patient rather than attempting to
impose something from the outside that might be unsuitable for the patient's individuality.
Most of the indirect forms of hypnotic suggestion that were pioneered by Erickson to
facilitate his utilization approach were developed in clinical practice and field experiments
without the benefit of detailed analysis or controlled experimental validation. In this volume,
therefore, we will begin the process of analyzing a number of these indirect terms of hypnotic
suggestion, first to achieve some understanding of their clinical application, and second, to
propose research that will be needed to further explore their nature and use. In this chapter
we will discuss "truisms" and "not doing, not knowing" as two of the most basic forms of
indirect hypnotic suggestion.

TRUISMS UTILIZING MENTAL MECHANISMS


The simplest form of suggestion is a truism—a simple statement of fact about behavior
that the patient has experienced so often that it cannot be denied. Erickson frequently talks
about such psychological processes as if he were simply describing objective facts to the
patient. Actually, these verbal descriptions can function as indirect forms of hypnotic
suggestion when they trip off associated ideomotor and ideosensory processes that already
exist within the subject (Weitzenhoffer, 1957); the truism can evoke and utilize the patient's
own repository of life experience, associations, and mental mechanisms. The Generalized
Reality Orientation (Shor, 1959) usually maintains these subjective associations and mental
mechanisms in appropriate check when we are talking in ordinary conversation. When
attention is fixed and focused in trance, however, the following truisms may actually trip off a
literal and concrete experience of the suggested behavior.
1. You already know how to experience pleasant sensations like the warmth of the
sun on your skin.

2. Everyone has had the experience of nodding their head "yes" or shaking it for
"no" even without quite realizing it.

3. We know when you are asleep your unconscious can dream.

4. You can easily forget that dream when you awaken.


Practical experience demonstrates that evoking a subject's personal experience by way
of a concrete image as illustrated in example 1 is an effective approach for evoking
ideosensory experience. The "idea" of warmth and the image of the sun on the skin evoke
personal associations from previous experiences that generate an actual "sensation" of
warmth on the skin. In a similar manner, talking about a common life experience like nodding
a head "yes" in example 2 is an "idea" that tends to evoke the actual "motor" response of
head nodding. Such ideomotor and ideosensory processes were early recognized as the
basis of many hypnotic phenomena (Bernheim, 1895), and they can be easily measured
today with psychophysiological instruments. Many forms of biofeedback (Brown, 1974), for
example, can be understood as ideosensory and ideomotor responses that are amplified and
reinforced by electronic instrumentation. More cognitive processes like dreaming and
forgetting can be facilitated when suggested by truisms that the average subject usually
cannot deny, as in examples 3 and 4. This, then, is a basic mechanism of hypnotic
suggestion: we offer simple truths that automatically evoke conditioned associations in a
particularly vivid way. Suggestion is a process of evoking and utilizing potentials and life
experiences that are already present in subjects but perhaps outside their usual range of
control. Therapeutic suggestion helps patients gain access to their own associations and
abilities to solve their own problem.

TRUISMS UTILIZING TIME


One particularly important form of truism is that which incorporates time. When Erickson
makes a request for a definite behavioral response, he usually tempers it with time. He would
never say, "Your headache is gone," because it might not be, and the patient would, with
some justice, begin to experience a loss of belief. Instead, Erickson turns the direct
suggestion into a truism by saying, "The headache is going to leave shortly." It could be a
few seconds, minutes, hours, or even days. In a similar vein, the following suggestions all
become truisms because the time factor allows patients to utilize their own associations and
experience to make them true.
Sooner or later, your hand is going to lift [eyes close, etc.].
Your headache [or whatever problem] will disappear as soon as your system is ready
for it to leave.
It probably will happen just as soon as you are ready. We will allow the unconscious
to take as much time as it needs to let that happen.

Exercises with Truisms


1. Plan how truisms utilizing mental mechanisms and time can be used to facilitate
trance induction and an experience of any of the classical hypnotic phenomena.
2. Do the same for any psychological function (e.g., memory, learning ability, time
sense, emotional processes) your patient is interested in exploring for therapeutic purposes.
3. Make up verbal suggestions that can be used to alter body temperature, digestion,
respiration, or any other psychophysiological function you have been trained to deal with in
your professional work. It might be well first to write down these suggestions in a direct form
and then convert them into truisms utilizing time and common everyday descriptions of
natural psychological and physiological processes.
4. Plan how truisms utilizing mental mechanisms and time can be used to help you
cope with typical clinical problems you have been trained to deal with.

NOT DOING, NOT KNOWING


A basic aspect of trance experience is allowing mental processes to take place by
themselves. We ask the subject to "relax and let things happen." Not doing is thus a basic
form of indirect hypnotic suggestion that is of particular value in inducing trance. Most people
do not know that most mental processes are autonomous. They believe they think by driving
and directing their own associative processes. And to a certain extent they do. But it comes
as a pleasant surprise when they relax and find that associations, sensations, perceptions,
movements, and mental mechanisms can proceed quite on their own. This autonomous flow
of undirected experience is a simple way of defining trance. Hypnotic suggestion comes into
play when the therapist's directives have a significant influence in facilitating the expression
of that autonomous flow in one direction or another.
When one is relaxed, the parasympathetic system is predominant, and one is
physiologically predisposed not to do rather than to make any active effort of doing. Because
of this it is very easy to accept the following suggestions for not doing during the initial stages
of trance induction.
You don't have to talk or move or make any sort of effort. You don't even have to
hold your eyes open.

You don't have to bother trying to listen to me because your unconscious can do
that and respond all by itself.

People can sleep and not know they are asleep. They can dream and not
remember that dream.
Not doing is a precondition for most hypnotic experience. Most hypnotic phenomena can
be experienced by relaxing to the point where we simply give up our habitual patterns of
control and self-direction. This is the opposite of the usual situation of everyday life, where
we make concentrated efforts to remember. In trance we are congratulated for forgetting
(hypnotic amnesia). In normal living we are enjoined to pay attention; in trance we are
applauded for allowing the mind to wander (reverie, hypnotic dreaming). In daily affairs we
are forced to act our age; in trance we achieve success simply by allowing a comfortable age
regression to take place. In normal life we continuously expend strenuous effort to achieve
veridical perceptions; in trance we allow sensory and perceptual distortions to take place and
can even indulge ourselves in hallucinations. From this point of view we can understand how
it is indeed much easier and enjoyable to experience trance than the extensive effort that is
required to stay normally awake!
Thus, Erickson's initial direction in trance training is to help the subject have a
comfortable experience in not doing. Frequently this can be experienced as momentarily
losing abilities that are usually performed in an automatic and unthinking manner. Subjects
can lose the ability to stand up or to keep a hand on the thigh. They can lose the ability to
focus their eyes and see clearly; they can lose the ability to speak. How often in everyday life
do we say, "I stood there like an idiot, unable to say anything or even think in that situation."
That is an example of the common everyday trance where for a moment we were lost in not
doing.
Closely related to not doing is not knowing. In everyday life we must continuously expend
energy and effort to know. How pleasant, then, to find a situation where we can relax and do
not need to know. What a relief! Most subjects can look forward to trance experience as a
newfound freedom from the demands of the world. They really don't have to know or do
anything; their unconscious can handle it all by itself.
To help subjects realize this, Erickson frequently gives a preinduction talk about the
conscious and unconscious—or the "front" and "back" part of the mind. He emphasizes how
the unconscious is usually capable of regulating the body (breathing, heartbeat, all the
physiological processes) and the mind all by itself. Indeed, people frequently have problems
because their conscious mind is trying to do something that the unconscious can do better.
He talks about infancy and childhood when one was "natural" and happy and did not know.
At one time one did not know how to walk or talk or even make sense of visual and auditory
impressions. One did not know that one's hand belonged to oneself, as when infants are
observed to reach for their right hand with their right hand. Erickson frequently introduces
puzzles and beguiling tasks to prove how amusing it can be when one does not know. He will
ask if a person knows whether he is right- or left-thumbed. Few people do. He then asks
people to put their hands behind their head and then fold their fingers together. The subjects
then bring their folded hands to their lap to learn whether their left or right thumb is on top;
that is the dominant thumb. Erickson then emphasizes how the patients' unconscious, their
body, knew this all their life even though their conscious mind did not. With many anecdotes,
stories, and interesting bits of behavior he carefully lays the groundwork to help patients
realize and value the fact that the unconscious knows more and that the conscious can help
best simply by relying upon the unconscious to do things. This permits subjects to adopt a
receptive and acceptance set wherein they become more acutely sensitive to their own inner
processes as well as the suggestions of the therapist.

Exercises with Not Doing and Not Knowing


1. Practice changing direct, positive suggestions into indirect suggestions of the "you
don't have to" form. For example, instead of "Remain quietly seated with your eyes closed,"
one may say "You don't have to move or even bother keeping your eyes open," or "You can
just remain comfortable and quiet and not bother with anything.")
2. Formulate suggestions for not doing and not knowing that are appropriate for the
induction and maintenance of trance.
3. Formulate suggestions for "not doing" that will achieve interesting (a) hypnotic
phenomena (catalepsy, anesthesia, age regression, etc.) and (b) psychotherapeutic goals
(coping with phobias, compulsions, habits such as nail biting, smoking, overeating; self
understanding, etc.).
TWO

Indirect Induction by Recapitulation


The indirect approach is a basic theme in Erickson's work and the source of a great deal
of his originality. In this session he reveals his beliefs about how a patient learns to
experience trance and illustrates many of his indirect approaches to suggestion. The
therapist helps the patient learn to experience trance by depotentiating conscious sets and
by creating a definite demarcation or dissociation between the trance state and the ordinary
awake state. One of the major controversies in the past few decades of research in hypnosis
has been between the traditional clinical view of trance as an altered state that is different
and discontinuous from being awake versus the theories of trance as a special form of role
playing (Sarbin and Coe, 1972), goal-directed imagining (Barber, 1972), or communication
(Haley, 1963). There can be no doubt that Erickson maintains the traditional view of trance
as a special state (Erickson and Rossi, 1974), but it is in his indirect approaches to
suggestion that he is most innovative and nontraditional.
In this session Erickson illustrates with simplicity and seeming casualness a few
cornerstones of the indirect approach: the yes set, implication, the double bind, and the use
of truisms to align a patient's associative processes for creative trance work. He also
illustrates indirect approaches for discharging resistance, utilizing personal motivation, and
facilitating new learning and individuality. He takes some initial steps toward training Dr. S for
the experience of dissociation, ideomotor signaling, hallucination, amnesia, posthypnotic
suggestion, and the separation of conscious and unconscious processes. We witness a
simple secret of the effectiveness of his approach: he offers suggestions in an open-ended
manner that admits many possibilities of response as acceptable. Suggestions are offered in
such a manner that any response the patient makes can be accepted as a valid hypnotic
phenomenon. These open-ended suggestions are also a means of exploring the patient's
response tendencies (the "response hierarchy" of learning theory and behavior therapy). The
therapist can utilize these response tendencies to effect therapeutic goals.
Erickson begins this session with an indirect induction by recapitulation. He does not
begin by directly asking the subject to recall and recapitulate experiences on the first session.
Such a direct request would only evoke a plaintive, "But I don't know how." Instead, in the
first sentence he utilizes her motivation for learning and then immediately touches gently but
completely on many associations that will automatically evoke memories of her previous
session and therefore tend to reinduce that trance.

Body Orientation for Trance


E: Both feet on the floor and your hands on your thighs, elbows at your sides.
Pick a spot here on this paper weight.
E: Here we exactly reproduce the previous hypnotherapeutic position. She went into a
trance the first time with this position, so the position will help her to do the same now.

Reorientation to Trance by Recapitulation


Now the thing for you to do,
actually for your own education,
your own training,
your own experiences,
is to look at a spot there,
anywhere you wish,
and try to recall
what I said to you
and keep on
thinking,
trying to recall
the formation of mental images,
of letters, numbers
the unimportance of keeping your eyes open
and then permitting Dr. Rossi and me to talk
while you listen
and then beginning to drift away.
(Pause)
R: This is a fantastic sentence; it completely recapitulates the first hypnotherapeutic
situation. You touch upon many associations to her previously successful hypnotic
work and thereby facilitate your current hypnotic induction. You also deftly utilize her
professional motivation by touching upon "for your own education." Instead of
suggesting eye closure directly at this point, you prepare for it indirectly simply by
mentioning "the unimportance of keeping your eyes open." I notice you use the word
"drift" here, which she introduced at the very end last time to describe her subjective
experience of entering a trance.
E: You always use the patient's own words and experience as much as possible for
trance induction and suggestion.

Direct Suggestion for Inevitable Behavior


Your eyes can now close,
R: This direct suggestion for eye closure was now more appropriate since she had that
fixed, glassy stare at this point. You only give direct suggestions when you're
absolutely certain the patient is ready to accept them.
E: It is always safe to suggest behavior that is inevitable in the natural course of things.
Implication
and you will note
that the drifting can occur
more rapidly.
That there is less and less importance
to be attached to my voice
and that you can experience
progressively
(pause)
any kind of sensations you wish.
E: By emphasizing "more rapidly" you imply that drifting will occur.
R: Implication is thus a safe way of evoking and talking about behavior that may or may
not be present. If you simply said, "You will now drift," that could arouse resistance.
E: For example, if I say, "I don't know what chair you are going to sit in ..."
R: That implies you will sit down; you are structuring their behavior, but so subtly that
it's not likely to arouse resistance.
E: Another example: Will you pay by cash or by check?
R: By using the word "progressively" you throw the statement "you can experience" into
an implication and then you pause to let it take place and the burden for it taking place
rests with the patient.
E: And I pause with confidence that it will.
R: Further, it is a very safe statement to make because they are certainly experiencing
some sensations. You give them permission to experience whatever they are
experiencing and then take credit for evoking it.
E: That's right.

Early Learning Set


Bear in mind that when you first formed an image of the letter "A"
it was difficult.
But as you continued in school
you learned to form
mental images of letters and words and pictures
with increasing ease
until finally all you had to do
was to take a look.
(Pause)
R: You're evoking the early learning set again just as you did in the first session.
E: You imply that just as you overcame difficulties in the past, so you will now.

Limiting Attention and Downgrading Distractions


In the matter of experiencing other sensations
you learn to recognize cold
warm
muscle tension.
E: All these things are taking place in her body, so I am limiting her attention to herself
and downgrading all outside distractions. By mentioning her "experiencing" I am
referring to her own history. I am now evoking her personal history, and she knows it
and cannot dispute it.

The "Yes Set"


In your sleep at night you can dream.
In those dreams you can hear
you see, you move
you have any number of experiences.
R: These are truisms about dreams. Your mention of "dream" tends to evoke partial
aspects of the dream state as contributions to the current trance experience. I notice
you frequently state obvious truths as if to evoke a yes set.
E: That's right! [Erickson here recounts how in his earliest experiences with hypnosis
he discovered that he could ask subjects a dozen or so casual questions and make
remarks that required an obvious "yes" answer so that positive momentum was
gradually built up until they would finally also agree to enter a trance and then succeed
in doing it.]
E: You also develop a yes set by saying, "You wouldn't do such and such," and they
answer, "Yes, I wouldn't."
R: For a person who is negatively inclined you would emphasize all the things they
wouldn't do.
E: And thereby evoke a "yes."
R: This is like mental judo. Actually it is a utilization technique: you are utilizing the
person's characteristic attitudes.
E: That's right.

Posthypnotic Amnesia
And as a part of that experience
is forgetting that dream after you awaken.
An experience of forgetting in itself
is an experience
that is not alien to anybody.
(Pause)
E: The mention of "forgetting" tends to evoke posthypnotic amnesia without direct
suggestion.
R: The verbal naming or description of a neuropsychological mechanism such as
forgetting tends to evoke it. This seems to be a fundamental method of modern
hypnosis.

Indirect Evocation of Personal Motivation and New Learning by


Implication
Now with your background
you'll have many questions about many things.
You really don't know what those questions are.
You won't know what some of those questions are until they are half answered.
E: "You'll have many questions" implies: you will want to learn all you can and therefore
you will participate fully.
R: You're evoking a learning set again.
E: And very forcefully.
R: By mentioning her "background" as a professional psychologist you evoke her
professional pride and personal motivation.
E: That's right! And without boldly identifying what you're doing.
R: Yes. You did not say, "Because you are a psychologist you are going to be
interested in this." You simply said, "with your background," and thereby evoked the
best of her personal pride in herself as a professional.

Indirect Evocation of New Learning


And sometimes the answers
seem to be one thing
and turn out to be another.
R: The implication here is that new learning will take place: new answers to change the
mental sets or mental habits that may be the source of a personal problem. You are
structuring a learning set for therapeutic change.
E: Yes, new and different learnings for psychotherapeutic change. Without saying "Now
I'm going to cram down your throat some new understanding."

Indirectly Discharging Resistance


The word April means a child—
it means a month.
(Pause)
But it can also mean April fool.
And so in your experiences be aware of the fact
that you really don't know where you are going to go,
but you are going to go.
R: Now you do a charming thing. You know that S has a young daughter named April,
and you talk about her here. Why?
E: She can say, "Let's not drag my child into this." Now notice my emphasis on "April
fool." All her rejection has to go on that one word.
R: I see. You've picked up her rejection with that one word "fool." You've crystallized
and discharged her resistance.
E: Discharged it!
R: "April fool" discharged all the contumacy of the situation. So if resistance was
building up you've discharged it here. You've discharged it indirectly with a pun.
E: Yes, and "April fool" also has pleasant associations. E: But this does imply that you
are going someplace.

Engaging Motivation with Patient-Centered Experience


It all belongs to you.
E: If it all belongs to you, you want to take charge of it, don't you?
R: The burden is placed on her for carrying out the experience; she is to be the source
of her own experience.
E: And because it belongs to her she wants it.
R: So you're again engaging her personal pride and motivating her.
E: That's right.

Hidden Directives by Implication


And it can be shared in any way that you decide.
E: You can't share a thing unless you've got it.
R: You imply there will be something to share. You again give the illusion of freedom
when you say, "And it can be shared in any way you decide," but the hidden directives
are (1) there will be something to share and (2) she will share it.

Evoking Courage and Self-Exploration


And one of the nicest things about hypnosis is
that in the trance state you can dare to look at
and think and see and feel things
that you wouldn't dare in the ordinary waking state.
E: I'm telling her that she has a lot more courage than she knows, and there will be
more to become aware of than she knows.
R: Which of course is a scientific truism again: there is much more in our memory
banks and associative structures than we are usually aware of in the normal conscious
state. You use this truism here to evoke a set for self-exploration.

Truisms Evoking Mental Mechanisms:


Protection and Flow from the Unconscious
And it is hard for any person to think that he can be afraid of his own thoughts.
But you can know that in this hypnotic state
you have all the protection of your own unconscious,
which has been protecting you in your dreams,
permitting you to dream what you wish,
when you wish,
and keeping that dream as long as your unconscious thought necessary,
or as long as your conscious mind thought would be desirable.
E: She has all the control.
R: She has all the protection she needs. She need not fear, her unconscious mind will
take care of her. Is that right?
E: Right!
R: You're again verbally describing a scientific truism or natural mental mechanism that
will by association tend to set that mechanism into operation. You earlier evoked
"forgetting" in this way and now self-protection as a means of deeply reassuring her.
Depotentiating Consciousness
But your conscious mind will keep it only with the consent of your unconscious mind.
R: Is this again putting the conscious mind under the control or protection of the
unconscious?
E: Yes. And it emphasizes that the unconscious can give to the conscious.
R: Again opening up a set for self-exploration, for things to flow into consciousness. I'm
seeing this more and more: you're again utilizing a natural psychological mechanism, in
this case the unconscious giving to the conscious, for therapeutic purposes here and
now.

Facilitating Latent Potentials


Now the important achievement
for you
is to realize
that everybody
does not know
his capacities.
(Pause)
E: Who is important? She is! When you stop to think about it, nobody does know his
capacities.
R: So again you're utilizing a scientific truism; in this case you're setting her up to
enhance her latent potentials in any possible way.
E: That's right.

Allowing Time for Suggestions


And you have to discover these capacities in whatever slow way you wish.
E: In other words, you don't have to feel you must do it instantly.
R: This is an important principle in administering suggestions. When you don't know
whether her unconscious is ready to carry out a particular suggestion, you allow her an
indefinite time period to carry it out. Allowing indefinite time for suggestions is thus a
fail-safe device. If the suggestion is not carried out immediately, it's not registered as a
failure. The suggestion remains in a latent condition until it can be carried out.
[Erickson now tells a case history wherein a patient called him up 16 years after the
termination of therapy to tell him of a new development in her life that was directly
related to something he had told her in trance.]

Patient's Central Role


And one of the things I want you to discover is
you don't need to listen to me.
R: Again dismissing the conscious mind in favor of the unconscious.
E: And I'm also saying, "I'm not the important person, you are."
R: I see, again emphasizing the central role of the patient. The patient tends to think
the therapist is the important person.
E: He isn't!
R: Patients keep pulling at the therapist for the cure, the magic, !. the change, rather
than looking at themselves as the change agent. You are continually putting the
responsibility for change back on the patient.
E: On to them always!

Words Evoking Mental Mechanisms


Your unconscious mind can listen
to me without
your knowledge
and also deal with something else at the same time.
(Pause)
E: A scientific truism, just as you step up and down from a curb without thinking about
it.
R: You actually are evoking this psychological mechanism of listening on an
unconscious level simply by describing it verbally. This is rather profound when you
stop to think of it: you are using words to describe certain psychological mechanisms
that you want to happen. Your verbal description evokes the psychological mechanism
described.
E: It does.

Facilitating Change and Development


A person seeking therapy
comes in and tells you one story that is believed fully at the conscious level
and in nonverbal language can give you a story that is entirely different.
And the unconscious mind has had little opportunity
to give recognition to its own ways of understanding.
R: Again a therapeutic truism, but why are you presenting it?
E: I'm telling them, "You really don't know what's wrong with you." You tell them that so
they won't think, "I know everything about my problem, my illness."
R: You're developing a learning set again for something new to come in. You're trying
to open up their horizon, their experience. That's what the cure is going to be. You say
the unconscious is going to have a new opportunity for expressing itself.
E: Too often the conscious behavior keeps you too busy so you deprive the
unconscious of an opportunity to express itself. It's another scientific truism.
R: And so stated here it opens up the way for change and inner development.

Indirect Suggestions for Head Ideomotor Signaling


We learned to nod our heads for "yes" to shake our heads for "no." (Pause)
E: That is a fact and you pause to let them reflect on the factual nature of that
statement. They have a chance to recognize that you are really speaking the truth.
R: This is actually your way of introducing her to ideomotor signaling. You don't tell her
to nod and shake her head for "yes" and "no." You simply mention the possibility of
nonverbal communication and let her own individuality decide how and when.

Facilitating Individuality
But that is not necessarily true of all people.
A cave people of the South Seas recently discovered have their own ways of
nonverbal communication
where the cues are much slighter than we have.
E: Yes. Now each of us is an individual.
R: I see, that is the implication in describing these cave people with "their own ways" of
communication. You are implying there is a place for her individuality, and you're
evoking it thereby.
E: Yes, evoking it thereby.
R: Because that in fact is the problem with patients: many of their symptoms and so-
called mental problems are due to a suppression of their individuality. The cure is to let
that individuality come out and flower in all its particular genius.
E: That's right. That's what you need to do, and that is why they are seeing you.

Ideomotor Signaling the Acceptance of Suggestions


And your willingness to rely upon your unconscious mind
to do anything that can be of interest or value to you
is most important.
[S begins to nod her head very slowly.]
E: Emphasizing she is going to do something.
R: The fact that she does begin the very slow, repetitive head nodding characteristic of
an autonomous ideomotor response may indicate that she is accepting your suggestion
to rely on her unconscious mind.

Open-Ended Suggestions:
Forgetting and Recall
Not only are you to learn positive things
but you need to learn negative things.
(Pause)
One of the negative things you need to learn is that of forgetting.
Consciously you can say to yourself,
"This I will remember."
To forget something seems very hard for some people.
And yet if they would look into their history,
they can forget as easily.
In teaching students in medical school
you tell them most impressively, "The examination will be held in such and such a
room at such and such a time and in Building C
and will begin at 2:00."
And they will all listen with great interest,
and you turn to leave the classroom
and you will see the students lean toward each other
and say, What day?
What hour?
Building?
You know they heard it,
and they forgot it immediately.
(Pause)
R: Here you again talk about forgetting and give common examples of forgetting in
everyday life to facilitate the possibility of evoking forgetting in the form of posthypnotic
amnesia. She continues her very slow, slight, and repetitive head nodding throughout
your words here. Does that mean she is accepting your ideas and will act upon them?
In this case will she forget and experience an amnesia?
E: At some level she is responding with recognition or acceptance of what I am saying.
But I don't know how she will act on it yet.
R: You can offer this loosely structured network of associations about forgetting, and it
may or may not actually trip off forgetting mechanisms in her own mind. You do not
impose suggestions or commands, you simply offer verbal associations that her
individuality may or may not utilize. Trance does not ensure the acceptance of
suggestions (Erickson and Rossi, 1975); it is simply a modality wherein the patient's
mental processes have an opportunity to interact in a more spontaneous and
autonomous manner with the therapist. At this early stage of trance training you are
simply exploring how her individuality will respond to suggestions you offer in an open-
ended manner.

The Apposition of Opposites


That is a facility in behaving that serves many good purposes.
And you should enjoy learning to forget not only ideas
but nonverbal performances.
Purposely forgetting that you know a certain name
doing as you did as a child
when you decided you liked a different name
and perhaps for a half day you entertained that your name was Darlene
or Ann Margaret
[S appears to renew her slow head nodding at this point in apparent recognition or
acceptance of what is being said.]
E: This is a very common game among children and it reminds her of a forgotten game.
R: Giving her yet another example of a forgotten experience. This is a way of proving
you can forget.
E: But they will recall the forgotten memory of their experience with the game.
R: They will do the opposite of forgetting when they recall; they then prove they have
forgotten.
E: And at the same time they are verifying the validity of what I have been saying.
R: And it is possible you may have elicited a forgotten memory. So you have done two
things that are the opposite of one another. You have facilitated forgetting and you
have facilitated recall. You are juxtaposing mental mechanisms that are usually very
delicately balanced: forgetting and recall. They are delicately balanced in our
neurophysiology, and you delicately balance them here for therapeutic purposes. We
will call this the apposition of opposites wherein you attempt to balance opponent
mental processes. This careful balance is another means by which you give her
individuality a chance to express itself.

Amnesia and Dissociation:


Losing Abilities
It's a very remarkable thing to discover
that you can lose an arm,
a leg,
an entire moment.
You can forget where you are.
(Pause)
R: Another set of examples of how forgetting can take place by dissociation.
E: And everybody has that experience.
R: Yes. You would never take a chance and say something that everyone doesn't
always have. You speak in truisms for complete acceptance. People have to accept
what you say because it is all true. You then pause to let them assimilate your
message.
E: And I'm evoking memories

Conscious and Unconscious


Now there are some different ways in which the mind can function
in which the unconscious can join with the conscious,
many different ways in which the unconscious can avoid the conscious mind
without the conscious mind knowing that it is
just received a gift.
(Pause)
R: A series of truisms about the relations between conscious and unconscious here.
You continually use these truisms to (1) establish that you are a reliable source of the
truth and (2) to evoke certain mental mechanisms and modes of functioning. When
these truisms do trip off the described psychological mechanisms (for example, the
unconscious releasing a forgotten memory to the conscious), you also thereby
establish the validity and value of trance in a very safe way. In therapeutic work you
never use direct challenges to prove the trance.
E: That's right.
R: This is a much more effective and interesting way of establishing the validity of
trance, and you are less likely to arouse resistance.

Facilitating Latent Potentials by Implication


The very complexity of mental functioning
you can go into a trance to find out
a whole lot of things that you can do.
And they are so many more than you dreamed of.
(Pause)
E: This implies: you do have an important purpose in going into a trance. It is not what I
can do but what you, the patient, can do. You emphasize all the things the patient can
do.
R: You are using implication to initiate a process of inner exploration that may facilitate
the recognition of potentials she did not know she had.

Evoking Early Experience


You can dream of yourself as a small child,
wondering who that child is.
(Pause)
R: This may be evoking early memories or an age regression, but with the safe
distancing device of "wondering who that child is." You do not precipitate the patient
into an actual experience of reliving the past since that might be traumatic at this early
stage of therapy.
E: You do not elicit the common response, "But I can't be a child." But they can wonder
who the child is. While they wonder they can say, "I can be that child."
R: You speak of it in the context of "You can dream of yourself as a small child." Is that
actually evoking mechanisms of dream formation?
E: Yes, and using them in another way.
R: So again you are utilizing a natural neuropsychological mechanism by evoking it
verbally.
E: And when you say, "You can dream," it implies you can also do it any other way you
want to.
R: You did not say, "You will dream of yourself." That would be limiting it to dreams
only. You say "You can dream" and imply, "But you could fantasize it, talk to yourself
about it, or whatever."
E: You can do it any way you wish, but you will do it.

Ratifying Age Regression


And you can watch that child grow older,
week by week,
month by month,
year by year.
Until finally you are able to recognize who that child is
who is growing up.
[S's head appears to nod very slightly.]
R: You are now ratifying the regression by having her watch herself grow up.
E: Yes, if she watches herself grow up, that implies and ratifies the fact that she
experienced herself as a child.

Facilitating Abilities via Dissociation


Every person has abilities
not known to the self,
abilities discredited by the self.
If there is an ability that the unconscious wants to disown,
it can examine that ability,
examine it very fully, very completely, and when it desires,
obliterate that ability
but doing so with an adequate understanding of the fact that an obliteration has been
effected.
[Here Erickson spends about 15 minutes giving a fairly complex clinical example of
how the unconscious can obliterate a memory.]
E: Everyone does this; a truism again.
R: By discussing this disowning of abilities you are actually setting the stage for
facilitating processes of dissociation?
E: You only obliterate when there is that ability. By actively illustrating it, you prove it is
there. Since it is there we will use it.
R: You are evoking the obliteration mechanism in the unconscious?
E: Yes, but only temporarily to let her know it is there.
R: Oh, are you implying that the unconscious has obliterated a lot of things but it can
also bring them forward when it wants to ?
E: Yes.
R: So you are setting her up for possible memory recall of anything the unconscious
has obliterated.
E: That's right. Only she does not know what you are doing. R: You are speaking
directly to her unconscious here.
E: And using her own growth and experience, that's all your talking about.

Implication Even in Direct Suggestion


Now I am trying to map out some things you can learn.
R: You make such a direct statement here. I'm shocked.
E: "I am trying," and since you feel kindly toward me this implies: you will help me.
R: Indirectly placing the essential burden on her again. So even when you make a
direct statement, you may be implying other things, and the really important suggestion
is contained in that implication.

Hallucination Training
Now in hallucinating visually
sometimes you want to start it by keeping your eyes closed
and knowing they are closed.
(Pause)
There is no set time
for you to learn
to remain into trances with your eyes wide open.
(Pause)
E: Here she is beginning to realize that a hallucination is not just a psychotic thing. She
can see it in her mind's eye.
R: You are redefining hallucination as something that can be seen in the mind's eye
with one's eyes closed. You're making it a safe and easy thing they can do.
E: It may look like a challenge, but it isn't one. You may "start it by keeping your eyes
closed" implies that it doesn't make a damn bit of difference whether your eyes are
open or shut.
R: Then you throw in the safety phrase, "There is no set time." It can happen now or
next week.
E: In the final pause you exude confidence.

Trance as Common Experience


You have already had some experiences of being in a trance with your eyes wide
open.
(Pause)
E: Anyone absentmindedly looking out the window during a lecture is experiencing
trance with eyes wide open. You are oblivious to the external lecture and your
surroundings as you tune into inner realities. Everyone has had that experience.
R: You are defining trance in this way: not paying attention to your immediate
surroundings, being off someplace else mentally.
E: Trance is a common experience. A football fan watching a game on TV is awake to
the game but is not awake to his body sitting in the chair or his wife calling him to
dinner.

Awakening as a Creative Option


Now, we'll shift over to another part of your learning.
You can awaken from the trance at will,
awaken by counting back from 20 to 1.
R: You seemed fairly tentative as you gave these awakening instructions. You thus
gave her a creative option to awaken at this time. But if she was absorbed in interesting
and important work at that moment, there was an implication that she could continue
for a while yet. This ensures that awakening will be a pleasant experience rather than a
rude interruption.

The Double Dissociation Double Bind:


Dissociation Training
You can as a person awaken,
but you do not need to awaken as a body.
(Pause)
R: With the following sentence this forms a double dissociation double bind.
E: Yes. You are making it possible for the subject to comprehend the idea of a
dissociation between the mind and the body.

Possibilities of Posthypnotic Suggestion


You can waken when your body awakes but without a recognition of your body.
(Pause)
E: Here I'm giving the possibility of posthypnotic suggestion.
R: Now this is a very important aspect of your technique. You give possibilities for
posthypnotic behavior and you wonder yourself which of these will be fulfilled. You
have no way of knowing which will be realized, but when they are, you can take credit
for them.
E: You take credit only when you are given credit.
R: You just smile when they fulfill a posthypnotic suggestion, and they know you've had
a hand in it, which you have.
E: But not to the extent that they think.
R: So throughout the induction you may give many possibilities of posthypnotic
behavior but not in a bold way, as 1 once did in my early work when I told a subject that
he would "casually touch the ashtray after the trance was terminated." When he
awakened, he said he remembered my posthypnotic suggestion but he "did not feel like
carrying it out." He came back the next session saying he had been preoccupied all
week with why he had not touched the ashtray. Obviously he was influenced by the
suggestion, but I presented it so directly that it aroused resistance and actually
precipitated a conflict between touching and not touching and the question "why" that
bothered him all week. It may be dramatic for the purposes of the stage hypnotist to
select subjects who will "obey direct commands," but the hypnotherapist who must
work with all patients must carefully study what natural tendencies the individual patient
has that can be funneled into therapeutically useful posthypnotic behaviors.

Exploring Identity Formation


Our understanding of ourselves is very complicated.
A child first learns,
I love me,
(Pause)
and then proceeds one day,
I love my brother, my father, my sister, but what the child
is saying—
I love the me in you.
(Pause)
And that's all the child does love.
The me in you.
(Pause)
As the child progresses,
(Pause)
the child now learns
to love your beauty, your grace, intelligence,
but that is his perception of the you.
(Pause)
R: Here the focus is on the person's identity and how it developed?
E: You're evoking, "I am me, I am doing this, I'm going to keep on doing this."
R: You're focusing on the work to be done by her in trance? E: Yes.
R: By this general description of identity formation you are offering a series of truisms
that may help keep her focused on her own individual inner work. You also may be
helping her explore important facets of the development of her own identity.

Positive Motivation and Reward in Trance:


Facilitating the Growth of Identity
In the final stage it is learning in your happiness
I will find my happiness,
(Pause)
and that is the separation of the identity of one person
from the identity of the other.

E: "In your happiness I will find my happiness." Everyone wants to give and find
happiness. Their happiness right now in the trance will be some accomplishment.
R: I see, you're actually motivating her to accomplish something for which she will be
happy. You do everything you can to create an atmosphere of positive motivation and
reward in trance experience. By interspersing this positive feeling within the general
context of exploring her identity, you also may be associating a reward with the
development and separation of personal identity. You are indirectly facilitating the
growth of her identity.
Spontaneous Awakening in a Give-and-Take Relationship
[Subject spontaneously opens her eyes and reorients to her body.]
R: You did not know she was going to open her eyes at this point?
E: No.
R: Yet you gave her the option earlier of counting from 20 to 1 to awaken. Your open-
ended manner gave her the creative option of awakening when she felt ready to. You
structured an awakening, yet you gave her the freedom of when even if it was
inconvenient for you.
E: That's right. You give them the freedom to awaken at the wrong time for you. Then
they are in the mood to continue for you.
R: There is a give and take in your relationship with patients.

Making Trance Safe:


Separating Conscious from Unconscious
E: Now, what's happened to you?
S: Me?
E: Yes, what happened to you?
(Pause)
You wait and don't discuss it because what you're going to do is separate your
understandings and clarify those and individualize them.
(Pause)
At the present time you have a partially conscious and partially unconscious
understanding, and we don't know where to place the emphasis.
(Pause)
R: Now that she's awakened, we enter that important period of ratifying the trance. Her
question, "Me?" implies she is not completely oriented yet. It takes most people a
moment or two to awaken from trance. That is another indicator of a genuine trance
experience.
E: You will "separate your understandings" implies: you have got understandings of two
varieties, conscious and unconscious.
R: And you are going to do more work on them as time goes on. E: That's right.

Structuring Frames of Reference for Clinical Inquiry


There is one thing in therapy that is so important.
(Pause)
When you touch upon another person's emotions,
(Pause)
you always touch tender places, and they don't know where those tender places are.
(Pause)
You have had your first experience of a quick withdrawal.
(Pause)
Maybe you were trying to find why you were withdrawing
or what you were withdrawing from.
S: I didn't know I was.
R: You say that you didn't know you were withdrawing front hypnosis?
S: Yes.
R: Here you soften any possible negative implications of her awakening by generalizing
about tender places and emotions in therapy. You provide a frame of reference for
talking about tender emotions. You avoid direct questioning about such tender spots
since that tends to arouse resistance and at best only elicits an answer that is hedged
by all sorts of conscious inhibitions and limitations. By simply providing her with a
gentle frame of reference, on the other hand, you're giving her an opportunity to say
something that's important if she wants to; you're providing her with an opportunity for
growth that is automatically appropriate for whatever level she is at, since she can
choose to say whatever she wants within the frame you've provided.
E: I'm asking for what she may be thinking without being blunt and putting her on the
spot.
R: Yes, your statement about withdrawing provides a frame that may enable her to say
something about whatever she might have experienced as negative. Her statement
that she did not know she was withdrawing indicates she feels her awakening was a
natural and satisfying termination rather than an abrupt withdrawal or escape from
something unpleasant in trance.

Distraction to Maintain Separation Between Trance and Waking Patterns


E: By the way, what time do you think it is?
S: I thought it was about 4:30.
E: Does it feel a half-hour has passed?
R: Were you trying to distract us by throwing in that question?
E: Yes. It was a distraction. You don't want too much self-analysis immediately. A
person freshly out of the trance is still lingering close to it, and unconscious knowledge
is easily available. You don't know if that should be used yet. So you distract them.
R: You want to make a definite separation between trance and waking behavior. You
don't want the in-between state that blurs the distinction.
E: You do not want to blur that distinction.

Making Trance Safe


S: Well, it's kind of hard to judge because I was flashing back to when I was 16. I think
the first time I went ahead in time to about 40 years of age and we were visiting April's
children and there were four kids that were climbing around a banyan tree.
R: You went into the future?
S: Yes, I lived in the future.
Well, I have thought about it, but I dreamed about it too.
E: Where was April when you were thinking about her and her children?
S: Where was she? I don't know where she was; it seemed as if she was off doing
something. She was going to be there soon.
E: Where was that place? What was that place?
S: She just had these girls playing around a banyan tree. Just some time in the future.
E: The implication of this, of course, is that S did want to have four children herself (this
was later verified as true), and she is now projecting it into a fantasy of the future when
she can play with her daughter April's four children. But she does not know I know this,
she does not know it herself. Her unconscious knows a lot she does not know. In not
promptly analyzing this and telling her about it, I've also let her know it is safe to
fantasize and project herself in this way.
R: Yes. You've made the trance experience safe for her. You did not learn anything
from her trance that is going to frighten or traumatize her life. You make the trance a
safe and pleasant experience.
E: And she can trust me.
R: So we go on talking about the trance in an intellectual way that's safe.
(Erickson gives an example of a patient who once slapped him across the face
because she was not yet ready to talk consciously about trance events she was still
partly associated with in the first moments of awakening.)

Subjective Experience of Trance:


First Step to Visual Hallucinations
E: Do you know what you just said?
S: No.
E: What is the approach some people make toward active hallucination?
S: A while before, you said something about not having to pay attention to your voice,
but your voice had already gotten pretty distant because 1 felt pretty relaxed. But you
mentioned something about hallucinations. Just about then I saw a great heart, and it
had different layers. I don't know if it had something to do with that (referring to the
irregular green-tinted glass she had used for an eye fixation point.) Well, when I first
looked at it, it looked like seaweed, but I was imagining I was just swimming along in
the ocean.
(Pause)
I guess I'm just skipping around now.
E: Yes. To get a real hallucination is an unreality, and what is more unreal than April's
four children?
S: Well, it was like a dream in that respect.
They were cute little girls climbing through the tree.
R: Here she gives an excellent description of some of the subjective experiences of
trance. Especially noteworthy is her comment to the effect that when she was relaxed,
your voice already became "pretty distant." In relaxation, then, we automatically
diminish the subjective experience of all the sensory modalities.
This is the basis of using relaxation and hypnosis for pain and similar problems.
Her internal imagery with eyes closed was a symbolic approach toward experiencing
visual hallucinations with eyes open. This was her first response to your earlier
suggestions about hallucinating visually.
E: And a very effective one. She is very sophisticated with terminology—more so than
she realized—and she betrayed that fact by seeing April's children.
R: Seeing April's children is in the visual modality, the modality of visual hallucinations.
E: Yes.

Reinforcing the First Stages of Visual Hallucinations


R: You saw all that? So this was your first approach to hallucinatory experience.
E: And very, very real approach, and the approach of someone who is sophisticated
without knowing that she is sophisticated.
R: And without knowing that she is approaching hallucinatory behavior.
E: At a completely sophisticated level.
R: Let me ask what you mean by "sophisticated."
E: She knows what hallucination is. She accepted my abstract and sophisticated
concept "hallucination" and used it to see an unreality projected into the future.
R: I can see we were both very quick to reinforce her first step toward hallucinations
with very supportive remarks here. It is also fascinating to see how she spontaneously
oriented herself into the future without any suggestion from you. I suppose this is how
most hypnotic phenomena were discovered. Someone does something interesting
spontaneously, and then an alert investigator tries to evoke it in others.

Trance Characteristics
S: Now, I'm trying to think better. It was kind of hard to think, flashing around in that
state.
R: In the trance it's harder to think?
S: Yes
(Pause)
S: Another thing flashed into my mind when Dr. Erickson mentioned going back and
assuming another identity. I used the name Amy for a while in high school because we
were all using different names. When you mentioned Ann Margaret, that Amy identity
flashed in my mind.
(S continues to recount other memories of her teen years that she touched upon in
trance.)
E: How long had it been since you thought about Amy?
S: About 20 years. That's funny. Oh well, I think you said something about awakening
by counting back from 20 or something, and I did it but then I didn't know if I was right
in waking up.
R: Such spontaneous comments as these about how hard it is to think in trance
suggest that trance (at least as she experienced it) is an altered state characterized by
less control over cognitive processes. Trance is a giving up of controls over internal
processes as well as external behavior. Thus processes of cognition, imagery, and
emotion are experienced as flowing by themselves in an involuntary manner.
Awakening is a process of reasserting control over thinking (as she expresses so well
here) and behavior (body reorientation).

Movements and Identity


E: You were giving signs that I had hit on a definition of identity.
R: What were the signs?
E: Movements in her muscles here and there, especially in the thighs.
R: I see, that's why you were watching her hands resting on her thighs. You were
watching those muscles. I also noticed her fingers were moving at a certain point. I'd
like to have you say more about this, Dr. Erickson. About the signs you were picking
up on her.
R: You mentioned that when a patient's identity is touched, they show certain body
movements. How would you suggest a beginning hypnotherapist train himself to deal
with this? Would you wake up a patient when he begins showing such movements and
ask about them or simply ask while the patient is in trance?
E: When you continue with one subject long enough, they will gradually tell you
everything without your even asking.
R: Sensing that S was caught up in her identity by observing the movements in her
muscles and fingers—did that motivate you to suggest termination by counting
backward from 20 to 1?
E: I knew she was going to wake up in a direct relationship to the identification with
maturity.

Spontaneous Finger Signaling


E: Usually a patient in a trance remains immobile. When you see her move, you
immediately try to connect the movement with the words you have been using.
R: When you see her finger move, you try to connect it with what you have been
saying?
E: Yes.
R: A more naive hypnotherapist, a beginner like myself, might think, "Oh she is just
waking up." But her awakening has psychodynamic meaning. You saw those twitches
starting to take place and you understood this as a show of recognition or identity
with what you were saying.
E: Yes.
R: After this session S casually mentioned to me that she had recently witnessed a
demonstration of finger signaling. She felt that even though you did not suggest the
possibility of finger signaling to her, the finger movements I noticed were her initial
efforts at finger signaling. She wanted to experience finger signaling because she was
fascinated with it when she had previously witnessed it. She therefore used this trance
as an opportunity to experience something she was interested in without even telling
you about it. She said she was surprised and delighted when she noticed that her
fingers moved all by themselves. It is a curious dissociation: she wanted to experience
finger signaling and yet she did it in an entirely spontaneous and autonomous manner.
Of course, her finger signaling could also be a generalization from your earlier
suggestions for head signaling.

Open-Ended Suggestions:
Unconscious Selection of Hypnotic Experience
S: What did they mean, if I wasn't aware of them?
E: You were having flashes of identity of yourself as a child, maybe flashes of your
identity as you grew, flashes of your identity as an adolescent, and then a very strong
identification of yourself as a woman.
R: So in this presentation, Dr. Erickson, you allowed her many possibilities. You used a
buckshot approach which allowed her unconscious to select just what it wanted to
experience. You offered suggestions in an open-ended manner.
E: Yes, you phrase your suggestions in such a manner that the patient's own
unconscious can select just what experience is most appropriate at that time.

THE "YES SET"


The "yes set" is another basic hypnotic form for coping with the limitations of a patient's
rigid and negativistic conscious attitudes. Much initial effort in every trance induction is to
evoke a set or framework of associations that will facilitate the work that is to be
accomplished. In the first session, for example, he evoked the "early learning set" as an
analog of the new learning situation that hypnosis represented for Dr. S. Just as she
successfully learned her ABC's, so she would successfully learn to experience trance. Thus,
the early learning set could itself be understood as a "yes set" serving as a framework to
orient her to the trance work at hand.
One of Erickson's favorite anecdotes is about a beginning student who discovered the
usefulness of the "yes set" in hypnotic induction. The student found himself confronted by a
hostile subject who adamantly refused to accept the possibility that he could experience
trance. The student, acting on a creative hunch, then simply proceeded to ask the resistant
subject a series of 20 or 30 questions all of which would elicit an obvious answer of "yes." All
sorts of simple and boring questions such as the following could be used.
Are you living at x address?
Do you work at x?
Is today Tuesday?
Is it 10:00 A.M.?
Are you seated in that chair?
Without realizing it the subject develops a "yes set" and also becomes a bit bored with
the situation. At this point the student finally asked again if the subject would like to
experience trance. The subject then acquiesced simply because of the "yes set" and his
desire to escape the dull circumstance of simply saying "yes" to obvious questions.

Exercises with the "Yes Set"


1. We believe the "yes set" is closely related to the concept of rapport, which has
traditionally been regarded as a basic feature of the therapist-patient relationship in hypnosis.
It is the essence of Erickson's approach to the "resistant" patient who is usually unable to
control his own antagonistic, defensive, and self-defeating behavior. Erickson (1964)
illustrates as follows:
Perhaps this can be illustrated by the somewhat extreme example of a new patient whose opening
statement as he entered the office characterized all psychiatrists as being best described by a
commonly used vulgarity. The immediate reply was made, "You undoubtedly have a damn good
reason for saying that and even more." The italicized words were not recognized by the patient as a
direct intentional suggestion to be more communicative, but they were most effective. With much
profanity and obscenity, with bitterness and resentment, and with contempt and hostility he related his
unfortunate, unsuccessful, repeated, and often prolonged futile efforts to secure psychotherapy. When
he paused, the simple comment was made casually, "Well, you must have had a hell of a good reason
to seek therapy from me." (This was a definition of his visit unrecognized by him.)
Plan how you can learn to recognize, share, and utilize a patient's own words and frames
of reference to facilitate the transformation of "seemingly uncooperative forms of behavior
into good rapport, a feeling of being understood, and an attitude of hopeful expectancy of
successfully achieving the goals being sought."
PSYCHOLOGICAL IMPLICATION
An understanding of how Erickson uses implication will provide us with the clearest
model of his indirect approach to hypnotic suggestion. Since his use of "implication" may
involve something more than the typical dictionary definition of the term, we will assume that
he may be developing a special form of "psychological implication" in his work. For Erickson,
psychological implication is a key that automatically turns the tumblers of a patient's
associative processes into predictable patterns without awareness of how it happened. The
implied thought or response seems to come up autonomously within patients, as if it were
their own inner response rather than a suggestion initiated by the therapist. Psychological
implication is thus a way of structuring and directing patients' associative processes when
they cannot do it for themselves. The therapeutic use of this approach is obvious. If patients
have problems because of the limitations of their ability to utilize their own resources-, then
implications are a way of bypassing these limitations.
If you sit down, then you can go into trance.
Any implication stated in the logical "if. . .then" form can be a useful way of structuring a
suggestion. The introductory "if phrase states a condition that is acceptable or easily
accomplished by the patient so that a "yes set" is created for the suggestion that follows in
the concluding "then" phrase.
Obviously, you are not going into a trance, now!
"Now" lasts only for a short while; the implication is that you will go into a trance as soon
as "now" is over.
Certainly your arm won't be numb before I count to five.
Implies it will be numb after a count of five.
In every psychological implication there is a direction initially structured by the therapist
and a response created by the patient. In the above we are initially structuring the
implications that will direct the patient's associations and behavior in predictable directions.
Exactly when the patient will go into trance or how numbness will be created, however, are
responses mediated on an unconscious level by the patient. Consider the following
examples:
Before you go into trance, you ought to be comfortable.
The most obvious implication is that one will go into trance after one is comfortable. The
very process of getting comfortable, however, also evokes many unconscious adjustments of
relaxation and not doing that are also important for initiating trance experience.
The very complexity of mental functioning,
A truism.
you go into a trance to find out
A phrase which implies that the patient does have an important purpose in going into a
trance.
a whole lot of things you can do.
This implies that it is not what the therapist can do but what the patient can do that is
important.
And there are so many more than you dreamed of. (pause)
The pause implies that the patient's unconscious may make a search to find some of
these individual things she was previously unaware of.
It is important in formulating psychological implications to realize that the therapist only
provides a stimulus; the hypnotic aspect of psychological implications is created on an
unconscious level by the listener. The most effective aspect of any suggestion is that which stirs
the listener's own associations and mental processes into automatic action. It is this autonomous
activity of the listener's own associations and mental processes that creates hypnotic experience.
There are, to be sure, crude and mostly ineffective uses of implication in everyday life,
where the speaker in a very obvious manner attempts to cast negative implications or
aspersions on the listener. In such crude usage the implication is obviously created entirely
by the speaker. In our use of psychological implication, however, we mean something quite
different. In the psychological climate of the therapeutic encounter the patient is understood
to be the center of focus. Every psychological truth is consciously or unconsciously received
by the patient for its possible application to himself. Psychological implication thus becomes
a valuable indirect approach for evoking and utilizing a patient's own associations to deal
with his own problem.
This was well illustrated when a colleague referred a rebellious teenager to Erickson. He
listened quietly to the lad's story and then initiated an important therapeutic development with
one simple statement.
I don't know how your behavior will change.
The rebellious teenager was in no mood to accept advice from a doctor, and, in truth,
Erickson really did not know how his behavior was going to change. By openly admitting that
he did not know, Erickson disarmed the lad's resistance so he could momentarily experience
an acceptance set. Erickson then managed to insert one implication in that moment of
acceptance: "Your behavior will change." The boy was now left with the idea of change; his
own associations and life experience would have to create exactly how that change was
going to take place.

Exercises in Psychological Implication


1. Exercises in implication and clinical inference were Erickson's first approach in training
the junior authors. He dragged out old protocols, some of them 25 years old or more, and
gave the junior authors the exercise of reading the first page or two and then, by implication
and inference, predict what was to follow. Another set of exercises was to study the first
sketch of a character by Dostoevski or Thomas Mann and by implication infer what the
character's fate would be in the novel. For a period of his life Erickson enjoyed whodunit
fiction for the same purpose. Study recordings of your own therapy sessions, particularly
initial interviews, and explore the possible implications of each of the patient's remarks. Then
study the implications of your own. How many are actually therapeutic?
2. Study recordings of hypnotic inductions, particularly your own. Learn to recognize the
implications that are present in your voice dynamics (such as intonations and pauses) as well
as the content of your words.
3. Carefully construct sentences that (a) state a general psychological truth that (b) by
implication initiates an inner search that will (c) evoke and mobilize the listener's own
memories, associations, ideomotor and ideosensory responses, and so on.
4. Carefully write out hypnotic inductions formulating a series of psychological
implications that can facilitate trance and each of the classical hypnotic phenomena.

THERAPEUTIC BINDS AND DOUBLE BINDS


The concept of the double bind has been used in many ways. We use the terms "bind"
and "double bind" in a very special and limited sense to describe forms of suggestion that
offer patients the possibility of structuring their behavior in a therapeutic direction. A bind
offers a free choice of two or more comparable alternatives—that is, whichever choice is
made leads behavior in a desired direction. Therapeutic binds are tactful presentations of the
possible alternate forms of constructive behavior that are available to the patient in a given
situation. The patient is given free, voluntary choice between them; the patient usually feels
bound, however, to accept one alternative.
Double binds, by contrast, offer possibilities of behavior that are outside the patient's
usual range of conscious choice and control. Since the original formulation of the double bind
(Bateson, Jackson, Haley, and Weakland, 1956) as a hypothesis about the nature and
etiology of communication in schizophrenia, a number of authors have sought to utilize the
concept of the double bind to understand and facilitate psychotherapy and hypnosis (Haley,
1963; Watzlawick et al., 1967, 1974; Erickson and Rossi, 1975). Since we use the term in a
very special and limited sense, we will present only an outline of how we conceptualize the
double bind for an understanding of therapeutic trance and hypnotic suggestion.
The double bind arises out of the possibility of communicating on more than one level.
We can (1) say something and (2) simultaneously comment on what we are saying. We may
describe our primary message (1) as being on an object level of communication while the
comment (2) is on a higher level of abstraction, which is usually called a secondary or
metalevel of communication (a metacommunication). A peculiar situation arises when what is
stated in a primary communication is restructured or cast into another frame of reference in the
metacommunication. In requesting an ideomotor response such as hand levitation, for example,
we (1) ask patients to let their hand lift but (2) to experience it as lifting in an involuntary manner.
In requesting an ideosensory response we may (1) ask patients to experience a hallucinatory
sensation of warmth, but (2) it is usually understood that such an experience is outside patients'
normal range of self-control. Therefore, patients must allow the warmth to develop on another,
more involuntary level. We have many ways of saying or implying to patients that (1) something
will happen, but (2) you won't do it with conscious intent, your unconscious will do it. We call this
the conscious-unconscious double bind: since consciousness cannot do it, the unconscious must
do it on an involuntary level. Conscious intentionality and one's usual mental sets are placed in a
bind that tends to depotentiate their activity; unconscious potentials now have an opportunity to
intrude. The conscious-unconscious double bind is the essential basis of many of the therapeutic
double binds discussed in the following sections.
In actual practice the metacommunication that comments on the primary message, may
take place without words: one may comment with a doubting tone of voice, a gesture or body
movement, subtle social cues and contexts. Hidden implications or unconscious assumptions
may also function as a metacommunication binding or qualifying what is said on the ordinary
conversational level. Because of this the patient is usually not aware that conflicting
messages are being received. The conflict is frequently enough to disrupt the patient's usual
modes of functioning, however, so that more unconscious and involuntary processes are
activated.
Ideally, our therapeutic double binds are mild quandaries that provide the patient with an
opportunity for growth. These quandries are indirect hypnotic forms insofar as they tend to
block or disrupt the patient's habitual attitudes and frames of reference so that choice is not
easily made on a conscious, voluntary level. In this sense a double bind may be operative
whenever one's usual frames of reference cannot cope and one is forced to another level of
functioning. Bateson (1975) has commented that this other level can be "a higher level of
abstraction which may be more wise, more psychotic, more humorous, more religious, etc."
We simply add that this other level can also be more autonomous or involuntary in its
functioning; that is, outside the person's usual range of self-direction and -control. Thus we
find that the therapeutic double bind can lead one to experience those altered states we
characterize as trance so that previously unrealized potentials may become manifest.
In actual practice there is an infinite range of situations that may or may not function as
binds or double binds. What is or is not a bind or double bind will depend very much on how
it is received by the listener. What is a bind or double bind for one person may not be one for
another. In the following sections, therefore, we will describe a number of formulations that
may or many not lead a particular patient to experience a bind or double bind. These
formulations are "approaches" to hypnotic experience; they cannot be regarded as
techniques that invariably produce the same response in everyone. Humans are too complex
and individual differences are simply too great to expect that the same words or situation will
produce the same effect in everyone. Well-trained hypnotherapists have available many
possible approaches to hypnotic experience. They offer them one after another to the patient
and carefully evaluate which actually lead to the desired result. In clinical practice we can
only determine what was or was not a therapeutic bind or double bind in retrospect by
studying the patient's response. The following formulations, therefore, offer only the
possibility of therapeutic binds or double binds that may structure desired behavior.

I. The Bind and Double Bind Question


Binds are easily formed by questions that give the subject a "free choice" among
comparable alternatives. Any choice, however, facilitates an approach toward a desired
response. To facilitate the acceptance of the trance situation a great number of possibilities
exist, such as the following:
Would you like to experience a light, medium, or deep trance?

Would you like to go into trance sitting up or lying down?

Would you like to have your hands on your thighs or on the arms of the chair
when you go into trance?
We could designate these questions as binds because while they do structure a trance situation,
they can easily be answered by most people with their usual conscious sets. For some people,
however, the second example could function as a double bind if it is found that they do, in fact, go
into a trance when they sit or lie down in response to the question.
The following questions, by contrast, are more typically double binds because they
cannot be answered with one's usual conscious sets. One must usually relax and allow more
autonomous or unconscious functions to fulfill them. Such double bind questions are of
particular interest for facilitating Erickson's experiential approach to hypnotic phenomena. By
turning attention to one's subjective experience, one is focused inward in a manner that can
lead easily to an experience of trance and hypnotic phenomena. This question approach is
also particularly suitable for those subjects who respond to the initial phase of trance
induction with hyperalertness, anxiety, or tension. The question allows them to utilize their
conscious focus to facilitate the recognition of the suggested phenomena. The question
double bind is thus very useful for "resistant" subjects, who need to use their consciousness
to maintain some control in the hypnotic situation. Consider these examples:
Will your right hand or your left begin to feel light first? Or will they both feel that
lightness at the same time?

Will your right hand move or lift or shift to the side or press down first? Or will it
be your left hand?

Do you begin to experience a numbness in the fingers or the back of the hand
first?

What part of your body begins to feel most comfortable (warm, cool, heavy, etc.)?
These questions may function as double binds because a hypnotic suggestion in the
form of an ideomotor or ideosensory response is being facilitated no matter which alternative
is experienced. When naive subjects experience such phenomena for the first time, they are
usually surprised and a bit delighted. Such phenomena are experiential proof that they can
learn to develop latent potentials and altered modes of functioning for further therapeutic
work.

2. The Time Bind and Double Bind


Time is an excellent dimension for formulating binding questions and situations.
Do you want to enter trance now or in a few minutes?

Would you like to go into trance quickly or slowly?


Will you be ready to get over that habit this week or the next?
These questions can be answered with one's usual frames of reference and may
therefore be classified as binds that simply focus attention in the direction of a desired
response. Whatever the patient's answer, however, they are being bound to make the
therapeutic response—either now or later. With some subjects the first two questions may
actually evoke the initial experiences of trance; for them the context of the hypnotherapeutic
situation and the therapist's attitude of expectation that they will go into trance may function
as metacommunications that activate autonomous processes leading them into trance
experience.
Double binds utilizing time to evoke responses on a more autonomous level may be
structured as follows:
Please let me know when that feeling of warmth develops in your hand. Is that
anesthesia proceeding quickly or slowly?

Take all the time you need to really learn how to experience that (any ideomotor or
ideosensory response) in that special trance time where every moment in trance is
equivalent to hours, days, or even weeks of regular time.
All of these questions and situations utilizing time contain a strong psychological
implication that the desired response will take place. Most hypnotic responses take time. In
trance subjects usually experience "psychomotor retardation." There is a lag between the
time when a suggestion is given and when the subject is finally able to carry it out. The time
bind capitalizes on this time lag and makes it an integral part of the hypnotic response.
A charming example of the possibility of a therapeutic double bind utilizing time was
offered to a six-year-old boy by Erickson.
I know your father and mother have been asking you, Jimmy, to quit biting your
nails. They don't seem to know that you're just a six-year-old boy. And they don't
seem to know that you will naturally quit biting your nails just before you're seven
years old. And they really don't know that! So when they tell you to stop biting your
nails, just ignore them!
Of course, Jimmy did not know that Erickson knew that he would be seven in a few
months. Erickson's words, uttered with sincere conviction and in a confidential tone implying
that he was taking Jimmy into secret confidence, were enough to double bind Jimmy into
giving up nail biting within two months in a way that the boy could not consciously
understand. He could not understand, for example, how his pleasure in being permitted to
ignore his parent's irritating demands that he stop biting his nails actually reinforced the
double bind that activated his own internal resources to create a way of giving up nail biting
on his own. As it turned out, Jimmy was later able to brag that he quit a whole month before
he was seven years old.

3. The Conscious-Unconscious Double Bind


Erickson frequently gives a preinduction talk about the differences between the
functioning of the conscious mind and the unconscious mind. This prepares the patient for
double binds that rest upon the fact that we cannot consciously control our unconscious. The
conscious-unconscious double bind blocks the patient's usual voluntary modes of behavior
so that responses must be mediated on a more autonomous or unconscious level. Any
response to the following situations, for example, requires that the subject experience trance.
If your unconscious wants you to enter trance, your right hand will lift. Otherwise
your left hand will lift.

You don't even have to listen to me because your unconscious is here and can
hear what it needs to to respond in just the right way.
And it really doesn't matter what your conscious mind does because your
unconscious automatically will do just what it needs to in order to achieve that
anesthesia [age regression, catalepsy, etc.].

You've said that your conscious mind is uncertain and confused. And that's
because the conscious mind does forget. And yet we know the unconscious does
have access to so many memories and images and experiences that it can make
available to the conscious mind so you can solve that problem. And when will the
unconscious make all those valuable learnings available to your conscious mind? Will
it be in a dream? During the day? Will it come quickly or slowly? Today? Tomorrow?
In this series of double binds the therapist is using an open-ended approach. The
therapist gives a number of truisms about psychological functioning, any one of which will
help to solve the patient's problem. The value of this open-ended approach is that it gives the
patient's unconscious the freedom to work in whatever way is most suitable for its own
unique patterns of functioning.
This open-ended approach, together with the conscious-unconscious double bind, is also
the essence of one of Erickson's approaches to resistant patients. When combined with
ideomotor signaling (as will be described in a later section) to indicate when the unconscious
has made a satisfactory response or answered a question, the conscious-unconscious
double bind becomes a reliable way of evoking hypnotic or involuntary responses in a
manner that is usually acceptable to even the most resistant, frightened, or misinformed
subject. In general, all the double bind approaches are excellent means for helping the so-
called resistant patient bypass or resolve the erroneous ideas and the limitations of his belief
system that have been impeding hypnotic responsiveness and therapeutic change.
Erickson introduced a series of interrelated double binds in this session that were all
directed toward depotentiating conscious sets by emphasizing the potency of the
unconscious over consciousness. Consider the following:
But your conscious mind will keep it only with the consent of your unconscious
mind.

You don't need to listen to me. Your unconscious mind can listen to me without
your knowledge.

A person seeking therapy conies in and tells you one story that is believed fully at
the conscious level and in nonverbal [unconscious] language can give you a story
that is entirely different.

And the unconscious mind has had little opportunity to give recognition to its own
ways of understanding. [Implying it would be well to give the unconscious that
opportunity now.]

And your willingness to rely upon your unconscious mind to do anything that can
be of interest or value to you as most important.

Now there are many different ways in which the mind can function in which the
unconscious can join with the conscious. Many different ways in which the
unconscious can avoid the conscious mind without the conscious mind knowing that
it has just received a gift.
If the reader studies the context of these remarks, it will be found that they are usually
directed toward freeing the patient's capacity for functioning on an unconscious level to
explore the many response potentials that have been excluded by consciousness. Learning
to experience trance and the response potentials that are available in trance is thus directly
related to the patient's ability to let go of the directing and limiting functions of his usual
frames of reference. Erickson demonstrates an important approach to separating conscious
from unconscious processes at the end of this session. He typically distracts patients for at
least two to five minutes after the formal termination of trance because, unless a patient has
been trained otherwise, it usually takes that long to fully separate trance and waking states.
The distraction period allows the associative connections to trance events to be broken.
Being so broken, trance events tend to remain amnesic. This also helps make a recognizable
demarcation between trance and wakefulness. This recognizable demarcation thus
automatically ratifies the fact that the trance was "real."
We view the typical experimental approach to hypnosis where the investigator
administers a standard scale of direct suggestions and then immediately questions subjects
about their experience as being destructive of the unique aspects of the first stages of
learning how to experience trance. Such immediate questioning blurs the still delicate
distinction between trance and waking states in subjects who are just learning how to let
themselves experience trance. The experimenter's immediate questions unwittingly build
associative bridges between the contents of the trance and the awake state. These
associative bridges actually destroy the experience of trance as an altered state that is
discontinuous from the ordinary awake state. It is an odd but sadly true fact that
consciousness usually does not recognize when it is in an altered state; people must learn to
recognize the delicate and nascent experience of developing trance just as they must learn
to recognize any other altered state (due to alcohol, drugs, toxemias, psychosis, etc.). It is
well established that the process of observation frequently interferes with the observed
process. This is particularly true for psychology in general and hypnosis in particular. Making
injudicious direct observations usually interferes with the trance phenomenon being
investigated.

4. The Double-Dissociation Double Bind


Erickson introduces another more complex double bind in this session to facilitate
dissociation. Note the subtle interlocking of the following suggestions for dissociation that
seem to cover all possibilities of response, while at the same time introducing the possibility
of certain posthypnotic responses.
You can as a person awaken but you do not need to awaken as a body. (Pause)

You can awaken when your body awakes but without a recognition of your body.
In the first half of this statement awakening as a person is dissociated from awakening as
a body. In the second half awakening as a person and body are dissociated from a
recognition of the body. Because of this we may call this type of statement a double-
dissociation double bind. So complex is the total effect of this suggestion that it is not
immediately obvious just what response possibilities are being suggested. The actual
response possibilities are as follows:
a. You can as a person awaken, but you do not need to awaken as a body.
b. You can as a person awaken, but you do not need to awaken as a body and
recognize your body.
c. You can as a person awaken, and you can as a body awaken, but without a
recognition of your body.
Hypnotic forms such as the double-dissociation double bind have an exciting potential for
exploring an individual's response abilities as well as mediating suggestions. As with open-
ended suggestions, double-dissociation double binds permit a certain amount of free choice
that enables a subject's individuality to express itself in ways that are surprising even to the
subject. Double-dissociation double binds tend to confuse subjects' conscious mind and thus
depotentiate their habitual sets, biases, and learned limitations. Under these circumstances
the field is cleared for the possibility of creative processes to express themselves in a more
autonomous and unconscious manner. We know from studies in neuropsychology (Luria,
1973) that the secondary and tertiary association areas of the parieto-temporo-occipital
context are capable of synthesizing and mediating the same psychological function in many
different ways. Hypnotic forms such as the double-dissociation bind may enable the subject
to exercise and utilize the incredible potentials of these association areas in ways that are
entirely new and outside the range of the subject's previous experience. Understood in this
manner, the double-dissociation double bind can be explored as a means of enhancing
creativity rather than simply programming suggestions.
Other examples illustrating possibilities of the double-dissociation double bind are as
follows:
You can write that material without knowing what it is then

you can go back and discover you know what it is without knowing you've done it.
Formulations such as the above for automatic writing with or without either a recognition
of its meaning or that one has written it are not as arbitrary as they may seem. Studies of the
secondary zones of the occipital cortex and optico-gnostic functions (Luria, 1973) illustrate
that each of the above possibilities can occur naturally in the form of agnosias when there
are specific organic disturbances to brain tissues. Each of these agnosias is possible only
because a discrete mental mechanism for normal functioning has been disturbed when it
appears. The agnosias are thus tags for identifying discrete mental mechanisms. A so-called
suggestion in the form of a double-dissociation double bind may be utilizing these same
natural mental mechanisms. We hypothesize that these mental mechanisms can be turned
on or off in trance even though they are usually autonomous in their functioning when a
person is normally awake. From this point of view we can conceptualize "suggestion" as
something more than verbal magic. Adequately formulated hypnotic forms actually may be
utilizing natural processes of cortical functioning that are characteristic of the secondary and
tertiary zones of cerebral organization. These processes are synthetic and integrative in their
functioning and are responsible for processes of perception, experience, recognition, and
knowing. Constructing hypnotic forms that can either block or facilitate these discrete
mechanisms of the secondary and tertiary zones thus has the potential for vastly extending
our understanding of cerebral functioning. This may be the neuropsychological basis for
using hypnotic forms for altering human behavior and greatly expanding all forms of human
experience.

5. A General Hypothesis About Evoking Hypnotic


Phenomena
Hypnotic forms such as the double-dissociation double bind also suggest a more general
hypothesis about the means by which traditional hypnotic phenomena can be evoked by
dissociation, providing another hint about how new hypnotic phenomena can be developed.
We may hypothesize that in general a hypnotic phenomenon takes place simply by
dissociating any behavior from its usual associational context. In our previous example
Erickson demonstrated how awakening as a body can be dissociated and separated from its
usual associational context of awakening as a person. When he demonstrates how not
recognizing one's body can be effected by dissociating the ability to see (or recognize one's
body) from its usual associational context with awakening as a person, he is actually
demonstrating how a negative hallucination can be evoked by a process of dissociation.
In a similar manner the traditional hypnotic phenomena of catalepsy can be evoked by
dissociating the ability to move a part of the body from its usual associational context of
awakening; anesthesia by dissociating the ability to feel; amnesia by dissociating the ability
to remember; and so on. The classical hypnotic phenomena of age regression, automatic
writing, hallucinations and time distortion can all be understood as "normal" aspects of
behavior that take place in an autonomous or hypnotic manner simply by separating them
from their usual associational contexts. It is now an exercise for the therapist's ingenuity to
locate those associational contexts from which any of these traditional behaviors can be
dissociated to evoke hypnotic phenomena in any particular patient. We can naturally expect
that there will be individual differences in the strength with which these various behaviors are
attached to different associational contexts in different subjects. The therapist's task is to
determine which behaviors can be most easily dissociated from which contexts in which
patients. Whenever a behavior is successfully dissociated from its usual context, we have
evoked a hypnotic phenomenon. As the therapist develops a facility for this approach, there
will be room for evoking entirely new effects that have not yet been reported in the literature.
An infinite number of hypnotic phenomena can be evoked for the purposes of basic research
and therapy.

6. The Reverse Set Double Bind


Erickson learned something about the reverse set double bind as a boy on the farm. He
recounts the events as follows: (Erickson and Rossi. 1975).
My first well-remembered intentional use of the double bind occurred in early boyhood. One winter
day with the weather below zero, my father led a calf out of the barn to the water trough. After the calf
had satisfied his thirst, they turned back to the barn but at the doorway the calf stubbornly braced its
feet and, despite my father's desperate pulling on the halter, he could not budge the animal. I was
outside playing in the snow and, observing the impasse, began laughing heartily. My father challenged
me to pull the calf into the barn. Recognizing the situation as one of unreasoning stubborn resistance
on the part of the calf, 1 decided to let the calf have full opportunity to resist since that was what it
apparently wished to do. Accordingly I presented the calf with a double bind by seizing it by the tail
and pulling it away from the barn while my father continued to pull it inward. The calf promptly chose to
resist the weaker of the two forces and dragged me into the barn.
Psychiatric patients are often resistant and withhold vital information indefinitely. When I observe this I
emphatically admonish them that they are not to reveal that information this week, in fact, 1 am insistent
that they withhold it until the latter part of next week. In the intensity of their subjective desire to resist, they
fail to evaluate adequately my admonition; they do not recognize it as a double bind requiring them both to
resist and to yield. If the intensity of their subjective resistance is sufficiently great they may take advantage
of the double bind to disclose the resistant material without further delay. They thereby achieve their
purpose of both communication and resistance. Patients rarely recognize the double bind when used on
them, but they often comment on the ease they find in communicating and handling their feelings of
resistance.
The reverse set double bind permits the subject both to resist and to yield! People with
problems are, in fact, usually caught between conflicting impulses. They are caught in
ambivalence between resisting and yielding to various impulses and trends within
themselves. An effective approach to resolving this dilemma is to allow both the resistance
and the yielding to be expressed. It does not make sense from a rational point of view—but it
does make sense from an emotional point of view—to free and express all the impulses that
were previously locked in mutual contradiction. A clear example of Erickson's use of the
reverse set to cope with contradictory, defiant, negativistic, and resistant behavior was
reported as an illustration of his utilization of the subject's own behavior to initiate trance
(Erickson, 1969). The first step is to carefully challenge the subject in such a way that a
reverse set is established; the subject is provoked to do the exact opposite of what Erickson
says. He then gradually introduces a series of suggestions the reverse of which will lead the
subject to experience trance.
The writer's utterances were carefully worded to elicit either verbally or by action an emphatic
contradiction from the heckler, who was told that he had to remain silent; that he could not speak
again, that he did not dare to stand up; that he could not again charge fraud; that he dared not walk
over to the aisle or up to the front of the auditorium; that he had to do whatever the writer demanded;
that he had to sit down; that he had to return to his original seat; that he was afraid of the writer; that
he dared not risk being hypnotized; that he was a noisy coward; that he was afraid to look at the
volunteer subjects sitting on the platform; that he had to take a seat in the back of the auditorium; that
he had to leave the auditorium; that he did not dare to come up on the platform; that he was afraid to
shake hands in a friendly fashion with the writer; that he did not dare to remain silent', that he was
afraid to walk over to one of the chairs on the platform for volunteer subjects; that he was afraid to face
the audience and to smile at them; that he dared not look at or listen to the writer; that he could not sit
in one of the chairs; that he would have to put his hands behind him instead of resting them on his
thighs; that he dared not experience hand levitation; that he was afraid to close his eyes; that he had
to remain awake; that he was afraid to go into a trance; that he had to hurry off the platform; that he
could not remain and go into a trance; that he could not even develop a light trance; that he dared not
go into a deep trance, etc.
The student disputed by word or action every step of the procedure with considerable ease until
he was forced into silence. With his dissents then limited to action alone, and caught in his own pattern
of contradiction of the writer, it became relatively easy to induce a somnabulistic trance state. He was
then employed as the demonstration subject for the lecture most effectively.
The next weekend, he sought out the writer, gave an account of his extensive personal
unhappiness and unpopularity and requested psychotherapy. In this he progressed with phenomenal
rapidity and success.
This technique, in part or in toto, has been used repeatedly in various modifications, especially
with defiant, resistive patients, particularly the "incorrigible" juvenile delinquent. Its significance lies in
the utilization of the patient's ambivalences and the opportunity such an approach affords the patient
to achieve successfully contradictory goals, with the feeling that these derived out of the unexpected
but adequate use of his own behavior. This need to meet fully the demands of the patient, however
manifested, ought never to be minimized.

7. The Non Sequitur Double Bind


Erickson uses non sequiturs or illogic as double binds. Non sequiturs and illogic tend to
bind, immobilize or disrupt a person's conscious sets so that choice and behavior tend to be
mediated on a more involuntary level. To the child who does not want to go to bed he might
first employ a time bind:
Would you rather go to sleep at 8:00 or 8:15?
Of course the child chooses the lesser of the two evils and agrees to go to bed at 8:15. If
there is any further difficulty, Erickson might employ an illogical but convincing double bind
such as: "Do you wish to take a bath before going to bed, or would you rather put your
pajamas on in the bathroom!" In such a non sequitur double bind there is a similarity in the
content of the alternatives offered even though there is no logical connection. One could get
vertigo trying to figure out the sense of such a proposition. Even though it is impossible to
figure out, one tends to go along with it when it is expressed in a confident and convincing
manner.

8. Contrasting the Therapeutic and Schizogenic Double


Bind
The relation between Erickson's therapeutic use of the double bind and the studies of it
by Bateson et al. (1972) in the genesis of schizophrenia offers an interesting study of
similarities and contrasts. We may list them side by side for comparison.
The Bateson Schizogenic Double Bind The Erickson Theraputic Double Bind
1. Two or more persons: The child "victim" Two or more persons: Usually patient and
is usually ensnared by mother or a therapist are ensconced in a positive
combination of parents and siblings relationship.
2. Repeated experience of the same One or more forms: of the double bind are
double bind rather than one simple offered until one is found that works.
traumatic event.
3. A primary negative injunction: "Do not A primary positive injunction: "I agree that you
do so-and-so or I will punish you." should continue doing such and such."
4. A secondary injunction conflicting with the A secondary positive suggestion at the more
first at a more abstract [meta] level, and abstract level that facilitates a creative
like the first, enforced by punishments or interaction between the primary (conscious) and
signals that threaten survival. metacommunication (unconscious).
5. A tertiary negative injunction A tertiary positive understanding (rapport,
prohibiting the victim from escaping the transference) that binds the patient to his
field. therapeutic task but leaves him free to leave if he
chooses.
6. Finally, the complete set of ingredients is The patient leaves therapy when his behavior
no longer necessary when the victim has change frees him from transference and the
learned to perceive his universe in double evoked double binds.
bind patterns.
It may be noted in summary that the schizogenic double bind uses negative injunctions that
are enforced at the metalevel, or abstract level, which is outside the victim's control and from
which there is no escape. Watzlawick, Beavin, and Jackson (1967) have illustrated the
therapeutic application of the double binds closely modeled on Bateson's formulation wherein the
patient is bound to a course of behavior change with no means of escape. Such double binds are
admittedly difficult to formulate, however. Erickson's double binds, by contrast, appear to be
looser in their formulation on the primary message level but more complex in utilizing many
aspects of the patient's unconscious dynamics simultaneously on the metacommunicative level.
Erickson's therapeutic double binds always emphasize positive agreement on the level of
metacommunication while offering possibilities that can be refused on the primary message level
if they are not appropriate. Erickson has stated, "While I put the patient into a double bind they
also sense, unconsciously, that I will never, never hold them to it. They know I will yield anytime. I
will then put them in another double bind in some other situation to see if they can put it to
constructive use because it meets their needs more adequately." For Erickson, then, the double
bind is a useful device that offers a patient possibilities for constructive change. If one double bind
does not fit, he will try another and another until he finds one that does.

9. The Unconscious and Metacommunication


Throughout this discussion of the varieties of double bind the reader may have noted the
ease with which we could use the terms "unconscious" and "metacommunication" in the
same place. These terms may in fact be in the process of becoming interchangeable. This
suggests we may be witnessing a fundamental change in our world view of depth psychology
whereby we are developing a new and more efficient nomenclature. Philosophers have never
liked the term "unconscious", it was the academic and philosophical rejection of this term that
impeded the early acceptance of Freud's psychoanalysis. The use of the term "unconscious"
still divides academic and experimentally oriented psychologists from clinicians as well as
doctors in physical medicine from psychiatry. The term "metacommunication", however, was
developed within a mathematicological framework, and as such, it fits in with the world view
of the research scientist as well as the clinician. It may well be that we are on the threshold of
a new Zeitgeist wherein we will revise the terms of depth psychology to make for a better fit
with current conceptions in mathematics, cybernetics, and systems theory.

Exercises with Double Binds


1. Construct your own original list of a variety of double binds with a positive
metacommunication to do the following:
a. structure a trance situation
b. structure each of the classical hypnotic phenomena
c. ratify trance
d. structure therapeutic alternatives for a variety of clinical problems (e.g., phobias,
compulsions, depression, anxiety, habit problems).
e. structure corrective action in various emergency situations
f. structure learning, creative imagination, and problem solving g. structure relations
between the conscious and unconscious
h. devise experimental situations to test which of your original double binds are most
effective
2. Explore the dynamics of double binds with negative metacommunications that
engender the following:
a. competitive situations
b. exploitive situations (economic, social, etc.)
3. What experimental situations can you devise to explore the relation between double
binds and such sociological catastrophes as wars and depressions and such psychological
problems as neurosis, psychosis, and phobias?

OPEN-ENDED SUGGESTIONS
Erickson ends the commentary to this session with an important admission. He
frequently uses a buckshot approach that offers the patient many possibilities of response in
an open-ended manner; thus, the patient's own unconscious can select just what experience
is most appropriate at that time." How different this is from the older authoritarian approaches
that belabor the patient with highly specific direct commands and suggestions! By offering
suggestions in such manner, he achieves three important goals:(l) There is no possibility of a
patient failing on a suggestion since all responses are defined as admissible hypnotic
phenomena; (2) patients' response abilities (the "response hierarchy") are explored to
provide clues as to what behaviors are available for the achievement of therapeutic goals; (3)
since anything the patients do is defined as an adequate hypnotic response, they cannot
resist or withdraw from the situation. Whatever they do tends to propel them further into the
hypnotic situation of following suggestions.
In his 1964 paper on his technique with resistant patients, for example, Erickson
manages to effect a dissociation between the conscious and unconscious while defining
practically any possible response on the conscious level as a valid hypnotic phenomenon. In
part it runs as follows:
"Now when you came into this room you brought into it both of your minds, that is, the front of
your mind and the back of your mind." ("Conscious mind" and "unconscious mind" can be used,
depending upon the educational level, and thus a second intimation is given of dissociation.) "Now, I
really don't care if you listen to me with your conscious mind, because it doesn't understand your
problem anyway or you wouldn't be here, so I just want to talk to your unconscious mind because it's
here and close enough to hear me so you can let your conscious mind listen to the street noises or the
planes overhead or the typing in the next room. Or you can think about any thoughts that come to your
conscious mind, systematic thoughts, random thoughts because all I want to do is to talk to your
unconscious mind and it will listen to me because it is within hearing distance even if your conscious
mind does get bored (boredom leads to disinterest, distraction, even sleep)."
In these few sentences the reader can observe not only how these suggestions admit
and define practically anything the conscious mind can do as a valid hypnotic response, but
also Erickson's simultaneous use of truisms, dissociation, implication, double binds, and
finally even an approach to depotentiating consciousness with boredom. This open-ended
approach of simultaneously using many possible means of effecting trance and suggestions
is highly characteristic of Erickson's style. We will study many illustrations of this open-ended
approach in each of the following sessions.

Exercises with Open-Ended Suggestions


1. Begin the practice of formulating suggestions in an open-ended manner that admits
and defines any possible responses as acceptable. This is particularly important in the
induction of trance, where both the therapist's and patient's fears of failure are most
pronounced. Formulating induction suggestions in an open-ended manner allows both
parties to relax. A premium is placed on exploration and on a convergence of expectations
in the patient and therapist that greatly facilitates rapport and therapeutic progress.
(Sacerdote, 1972).
2. When in doubt about where a patient is in trance or what can be experienced,
formulate suggestions in an open-ended manner that admits any kind of response as
adequate.
3. When in doubt about a patient's readiness to experience a particular phenomenon,
formulate open-ended suggestions that admit any degree of that response as adequate. It
will be useful for the beginning hypnotherapist to know and learn to recognize all possible
degrees or increments of response for all the classical hypnotic phenomena.
4. Learn to formulate therapeutic suggestions in an open-ended manner that admits no
possibility of failure.

SUGGESTIONS COVERING ALL POSSIBILITIES OF A


CLASS OF RESPONSES
Closely related to open-ended suggestions, but opposite in direction, are suggestions
that are carefully formulated to cover all possibilities of a class of responses. While open-
ended suggestions accept any response as valid, suggestions covering all possibilities of a
class of responses usually restrict the patient to a narrow range of acceptable possibilities.
The open-ended suggestion admits an essay of any possible response that allows the
patient's originality to become manifest. Suggestions covering all possibilities of a class of
responses restrict the patient to a relatively narrow range of choices within which he can
respond. Erickson (1952) illustrates this approach in his hand levitation technique of
induction as follows:
Shortly your right hand, or it may be your left hand, will begin to lift up, or it may
press down, or it may not move at all, but we will wait to see just what happens. Maybe
the thumb will be first, or you may feel something happening in your little finger, but
the really important thing is not whether your hand lifts up or presses down or just
remains still; rather, it is your ability to sense fully whatever feelings may develop in
your hand.
While open-ended suggestions are useful in exploring a patient's response potentials,
the suggestions that cover all possibilities of a class of responses are more useful when we
wish to funnel a patient's responses in one definite direction. To move a subject in the
direction of experiencing anesthesia, for example, one could proceed with suggestions
covering all possibilities of a class of responses somewhat as follows:
Now you can notice just where that arm is feeling something and where it is not.
Just where it may tingle or be numb or not feel anything at all.
When the patient indicates there are areas where the arm is numb or without sensation,
the therapist can then proceed with exploratory questions that allow the anesthesia to spread
to the desired area. To explore the possibility of alterations in visual perception and for
positive or negative hallucinations one could proceed somewhat as follows:
And now or in a few moments when your unconscious is ready there may be a
blankness or a haziness in your visual field. (Pause) And how will that haziness
develop? Will there be a fog or shadows? And when will the shadows begin to arrange
themselves into definite forms? (Pause) Will your eyes be open or closed? (Pause) It
will be interesting to find out whether it will be hazy or foggy or blurred. Or will things
be unusually bright, sharp, and clear when you open your eyes? Will there be an
alteration of the color background? Will some things be unusually clear and other
things not seen at all? You can wonder and wait comfortably as that develops.
This series of suggestions admits just about any possibility of a response in altered
visual perception as a successful and interesting experience. It helps patient and therapist
explore what response potentials for altered perception are available to the patient at this
particular time and place.

Exercises in Covering All Possibilities of a Class of


Responses
1. Plan how you could formulate suggestions covering all possibilities of a class of
responses to funnel the patient's responsivity toward the experience of each of the classical
hypnotic phenomena. (Erickson provides an unusually clear example of this with time
distortion in the next chapter.)
2. It can be interesting to practice suggestions covering all possibilities of a class of
responses in common everyday situations such as dining, recreation, shopping and so on.
Suggestions outlining the possibilities of the what, where and when of such activities can
enhance freedom of choice for your partner.

IDEOMOTOR SIGNALING
Ideomotor signaling may be the most useful hypnotic form discovered within the past
half-century. Erickson (1961) has reviewed the series of discoveries that led him from the use
of automatic writing to his development of hand levitation and finally ideomotor signaling
during the 1920s and 1930s. Erickson (1964c) has outlined a complete introduction to
ideomotor signaling for facilitating trance induction, trance deepening, and communication in
trance with the following words. The italics are placed by Erickson to make clear to the
reader where indirect suggestions are being made. The reader should be able to recognize
where conscious-unconscious double binds are being formulated.
"Something everybody knows is that people can communicate verbally ["talk by words" if
warranted by low educational or intelligence level] or by sign language. The commonest sign
language, of course, is when you nod your head yes or no. Anybody can do that. One can signal
'come' with the forefinger, or wave 'bye-bye' with the hand. The Finger signal in a way means 'Yes,
come here,' and waving the hand means really 'No, don't stay.' In other words one can use the head,
the finger or the hand to mean either yes or no. We all do it. So can you. Sometimes when we listen to
a person we may be nodding or shaking the head not knowing it in either agreement or disagreement.
It would be just as easy to do it with the finger or the hand. Now I would like to ask your unconscious
mind a question that can be answered with a simple yes or no. It's a question that only your
unconscious mind can answer. Neither your conscious mind nor my conscious mind, nor, for that
matter, even my unconscious mind knows the answer. Only your unconscious mind knows which
answer can be communicated, and it will have to think either a yes or a no answer. It could be by a
nod or a shake of the head, a lifting of the index finger, let us say, the right index finger for the yes
answer, the left index for a no since that is usually the case for the right-handed person and vice versa
for the left-handed person. Or the right hand could lift or the left hand could lift. But only your
unconscious mind knows what the answer will be when I ask for that yes or no answer. And not even
your unconscious mind will know, when the question is asked, whether it will answer with a head
movement, or a finger movement, and your unconscious mind will have to think through that question
and to decide, after it has formulated its own answer, just how it will answer." (All of this explanation is
essentially a series of suggestions so worded that responsive ideomotor behavior is made contingent
upon an inevitable occurrence, namely, that the subject "will have to think" and "to decide" without
there being an actual request for ideomotor responses. The implication only is there, and implications
are difficult to resist.)
We believe that for such ideomotor signaling to be truly autonomous and unconscious,
patients should be in trance or distracted in one way or another so they will not have an
opportunity to observe their own movements. Because of this Erickson frequently prefers to
look for automatic head nodding or shaking where patients are least likely to observe
themselves. It is surprising how often patients will nod or shake their heads to contradict their
own verbal statements even without any formal instruction about ideomotor signaling.
Frequently it is a very slow and slight but persistent head nodding or shaking that
distinguishes the movements as coming from an unconscious level. These slow, abbreviated
movements should be distinguished from larger and more rapid head movements that are
more consciously used as a way of emphasizing what is being said verbally.
We prefer to utilize a patient's own natural means of ideomotor signaling whenever
possible. Whatever natural and automatic movements a patient makes in ordinary
conversation can be studied for their metacommunicative value. Besides the more obvious head
and hand movements, eye blinking (slow or rapid), body shifting, leg movements, arm position
(e.g., crossed over one another as a "defense"), lip wetting, swallowing, facial cues such as
frowning and tensions around the mouth and jaw can be studied for their commentary on what is
being said verbally.
Since Erickson's introduction of ideomotor signaling other investigators (Le Cron, 1954;
Cheek and Le Cron, 1968) have explored its usefulness in facilitating a variety of hypnotic
phenomena. A most important aspect of sound hypnotic work is to know where the subject is
at all times. Many subjects are reluctant to speak in trance, and when they do so their usual
patterns of waking associations and behavior may be aroused, thus tending to suppress the
autonomous aspects of trance experience. Ideomotor signaling appears to be a response
system that can function more autonomously than speech. As such, ideomotor signaling is a
more convenient form of communicating during trance. Subjects comment that it is easier to
move a finger or hand or nod a head in trance than to talk. It tends to ratify the reality of their
trance as an altered state when they realize their ideomotor signals are autonomous: they
are experienced as taking place spontaneously without making any conscious effort to move.
In practice there are many possible relations between awareness, volition and ideomotor
signals. Initially many subjects realize they "know" or can "feel" what movement will take
place before it does. Because of this they are not certain whether the ideomotor movement
was truly autonomous or whether they actually helped it. With deepening experience of
trance there is less awareness of the movements, and they are accepted as being more truly
autonomous. With other subjects, perhaps those who are already experiencing trance
without realizing it (the "common everyday trance" wherein one's attention is fixed and
focused so that the surrounding reality is ignored, such as when one is absorbed in listening
to an interesting speaker, watching a movie, reading a book), the ideomotor movements
come autonomously entirely as a surprise. These subjects are fascinated with them and
wonder what responses will be given. The ideomotor movement obviously comes before they
"know" what the answer will be. Other subjects tend to experience ideosensory responses
before the actual ideomotor movement. They will "feel" an itch, prickliness, warmth, or some
other sensation in the finger before it moves.
An uncritical view of ideomotor signaling takes such movements as the "true response of
the unconscious." This is particularly the case when patients say one thing verbally but
contradict themselves with ideomotor signals. Although there is much clinical experience to
suggest that such contradictions are important clues about conflicts that the patient may not
be aware of, there is to date no controlled experimental research that confirms this view.
Because of this it is better at this stage of our understanding to view ideomotor signals simply
as another response system that must be studied and checked—just as any other verbal or
nonverbal form of communication must be. Ideomotor signals are particularly interesting in
trance work because they are a system of communication that is compatible with the
autonomous aspects of trance experience.

Exercises With Ideomotor Signaling


1. Study the historical aspects of ideomotor signaling in the form of the thought reading
experiments of the 19th century (Drayton, 1899), mediumistic phenomena such as table
turning and the Ouiji board (Bramwell, 1921), the Chevreul pendulum (Weitzenhoffer, 1957),
etc. Much of the so-called occult and psi phenomena may be understood as involuntary
muscular movements and ideomotor and ideosensory responses that are
unconsciously sent and received.
2. Study all varieties of apparently involuntary muscular movements as forms of
ideomotor signaling in everyday life. Notice how people will unconsciously nod or shake their
heads and move their lips, hands, and fingers when engaged in internal dialogue. Learn to
read faces; learn to recognize the minute facial movements that indicate changes in mood
and feeling. Study body posture and movements as nonverbal forms of communication
(Birdwhistell, 1952, 1971; Scheflen, 1974).
3. Plan how you can introduce ideomotor signaling as a natural form of autonomous
communication during trance in ways that can fit the individuality of each patient.
4. Learn to formulate suggestions so that the patient will give ideomotor signals when
an internal response (experiencing warmth, anesthesia, hallucinations, etc.) has been
experienced. Ideomotor signals can be combined with the implied directive (see Chapter 5)
to set up a communication system that can greatly facilitate trance training and the
experience of all the classical hypnotic phenomena.
5. Plan and carry out carefully controlled clinical and experimental situations to evaluate
the reliability and validity of ideomotor and ideosensory signaling.
THREE

The Handshake Induction


Erickson continues his indirect approaches in this session with the addition of his
nonverbal handshake induction. A major problem in helping Dr. S learn to experience trance
is to loosen the highly intellectualized and rigidly structured reality orientation she has
constructed in her many years of formal education. The nonverbal techniques (Erickson,
1964a) are particularly suitable for this task since they distract and promote the confusion
that Erickson now acknowledges as a basic process in his approaches to induction.
Dr. S immediately experiences catalepsy, the fogging phenomenon, restricted
awareness and comfort which are among the classical indicators of trance. By the end of this
session she is reviewing and possibly recovering forgotten memories; surprisingly, she is
also beginning to experience a spontaneous anesthesia that was not suggested. Erickson
likes to point out that it is in the spontaneous experience of such classical phenomena (along
with other psycho-physiological indicators such as diminished pulse, and respiration) that can
be taken as the most valid criteria for the reality of trance as an altered state.
This session brought to the fore two potent indirect approaches that were not identified
earlier: conditional suggestions and compound suggestions. Erickson had been using them
all along, of course, but this is the first time the Rossies have noticed them. Also noticed for
the first time was his routine reliance on the ratification of trance phenomena as an indirect
means of reinforcing suggestions. Erickson's use of the term "ratification" is similar but not
identical to the term "reinforcement" in psychological theory. Ratification refers specifically to
the patient's belief system. To ratify something means to confirm (reinforce?) that something
has occurred. Specifically, in hypnotic work Erickson uses the word "ratify" with regard to
hypnotic phenomenon he wants patients to experience and believe they are experiencing. To
ratify the trance is to help patients realize and believe they did experience trance. To ratify
the regression means that patients will later acknowledge that they did indeed experience a
regression.

Confusion in the Dynamics of Trance induction


E: Now silently, mentally, count backwards from 20 to 1.
You can begin the count, now.
[Erickson shakes hands with S but lingers before releasing her hand. Gradually, and
with seeming hesitation, he alternately applies and releases pressure with his fingers
on different parts of her hand. S is not even sure when he finally disengages his hand.
Her hand is left in a cataleptic position in midair. During this handshake Erickson
looks toward her face but focuses on the wall behind her. She looks at his face and
seemingly tries to capture his gaze or note whether or not he is actually looking at her.
She seems a bit disconcerted by his faraway gaze.]
E: Her disconcerted feeling is a mixture of her imperfect touch with reality. It is her
intellectual awareness that something has happened and her puzzlement about what
did happen. She is not really comfortable about it; she is trying to resolve it and is
experiencing difficulty in resolving it. That is a sophisticated subject's reaction.
R: That is an intellectually sophisticated subject's reaction to trance induction?
E: Yes. That is a very common reaction.

Confusion in Trance Induction


E: Do you think you're awake? [Said without altering his faraway gaze past her.]
R: Now you ask this question that is so characteristic of you, "Do you think you are
awake?" Why?
E: It means, "There is a good possibility that you are asleep and don't know it."
R: That's the implication. E: It arouses strong doubts in them, and it makes them very
uncertain. If a stranger comes up to you and says, "Do you know me?" it makes you
question and search through this memory and that.
R: So it puts the person in perplexity.
E: Yes, perplexity, and it emphasizes the conditional trance. It gives body to the trance.
R: I see. It begins to reinforce the trance, which her disconcerted feeling indicated was
already beginning. The handshake induction wherein she is not sure when you remove
your hand, then, begins a process of puzzlement about what is real and not real. The
dynamics of this induction is essentially a kind of confusion technique.
E: Yes, it is a confusion technique. In all my techniques, almost all, there is a
confusion. It is a confusion within them.

Unconscious Contexts as Metacommunications


S: I never really know, [laughs]
R: This immediate response reaffirms and ratifies the beginning trance.
E: When she says, "I never," she unwittingly attaches it to all other contexts with you.
Only she doesn't know she is doing that. When you "don't know," you are admitting you
want to know and you are willing to let the other person direct you.
R: I believe this is a very important point you are making. When she says, "I never
really know" [with you], it may seem like a simple casual statement, but you believe it is
an exact statement of her relation to you even though she herself does not realize the
significance of her statement. Actually she is making a metacommunication; she is
communicating about her communication to you. Most metacommunications are made
unconsciously (Bateson, 1972).

Fogging Phenomenon
I am. I guess — I'm a little fogged up. (Pause)
E: The fogging is a dimming of reality.

Double Bind Question Implying Altered State


E: Do you really think you're awake?
E: My asking the question also implies: you're different, you are in a different state now.
But she doesn't know I'm implying that.
R: The doubt you have in your voice when you ask this question turns in into a double
bind: if she answers "yes" she is acknowledging only that she thought she was awake
but must now reconsider in the light of your doubt; if she answers "no" she admits she
was not awake. You are again catapulting her into trance without her knowing why. It is
these unobserved maneuvers on your part that are so effective in inducing trance and
facilitating the acceptance of suggestions. They are effective because they structure
contexts (metacommunications) and initiate associations in a manner that circumvents
patients' conscious sets and all their usual objections, biases, and limitations.
Structuring Self-Suggestions
S: No. [laughs] I'm really comfortable.
(Pause)
[Erickson continues to look toward her but focuses beyond.}
S: You're staring [laughs].
E: Her statement about comfort is a way of reassuring herself, you have to be altered in
some way to have a reason for talking about your comfort. It also implies she is going
to stay in that state and intensify it. That is what you are avoiding saying to the subject
but get the subject to say themselves.
R: "I'm comfortable and I'm going to stay here and get more and more comfortable,"
which means going more and more into trance. It is characteristic of your approach that
you structure circumstances so the patient makes the appropriate self-suggestions
rather than you making a direct suggestion and risking the attendant possibility that the
patient might reject it. It is much more effective if you can structure their associative
processes without their awareness that you are doing it.
E: That's right. There is no need to say, "you are going in deeper and deeper."

Comfort as Characteristic of Trance


R: Now, just as catalepsy, or "stopped vision," is a characteristic of trance, would you
say that comfort is a characteristic of trance?
E: Yes, because you said you're comfortable, you are going to make even the
uncomfortable chair comfortable. That requires cooperative activity on your part.
R: So we can say that comfort and wanting to make yourself comfortable are
characteristic of trance.
E: Yes. Since it is awfully uncomfortable to lose reality, you have to replace that reality
with another.
R: That other reality is "comfort."
E: That is correct.
R: She also laughs at that point.
E: The laugh is a defensive reaction, and you don't have to defend yourself unless
there is a threat.
R: Which is the loss of "outer" reality.

Experiencing a Limited Awareness


I feel kind of funny since my left eye muscle kind of winks closed.
E: Here she is only able to muster up enough awareness about one eye.
R: She is not cognizant of the fact that her awareness is actually limited to her left eye
at this point It is from just such apparently innocuous remarks that you make important
inferences about the patient's consciousness.

Structuring Expectancy to Facilitate Hypnotic Responsiveness


E: [To Dr. Rossi but without altering the faraway gaze past S.] Notice the silent waiting,
the expectancy in her. So far as the patient knows you are not pressuring, you're
waiting. You are letting the patient discover how she can enter the trance.
E: You can't wait for something without knowing it is going to happen.
R: Your waiting has the hidden implication that trance will happen. It is only an
implication but it actually structures behavior without the patient being aware of it. You
have structured an expectancy in her that may initiate her into a response
attentativeness to any minimal changes in herself that can be the first signs of a new
hypnotic experience.

Trance Indicators in Casual Behavior


[Subject plays absent-mindedly with her dress and touches the back of one hand with
the other.]
You notice how occasionally she feels herself or she drags herself out of the
developing trance by looking over at you?
E: She plays with her dress, but even that is not real enough now, so she goes to
touching her hand.
R: This touching of herself is a stereotyped effort to reestablish the reality that is now
being rapidly dissociated. Actually, it is an indication of self-absorption and a restricted
awareness of anything outside herself. That, of course, is a way of defining trance
experience.

Hallucination Training
Now the next thing for her to do
is actually to develop an hallucination
of, let us say, a specific landscape.
One that she has not seen previously.
But a landscape she would like.
(Pause)
Now, who knows what she would put in a landscape?
Birds, trees, bushes, rocks.
R: Why the remark about a landscape she has not seen previously?
E: I could see she was searching through her memory, but to have her make
something I would like to turn her in on herself still more. By naming the specifics of
birds and trees I focus her attention more closely and more narrowly. I can direct her
attention without saying exactly how.
R: I've had difficulty in my beginning work with hypnosis in knowing just where the
patient is. That's because I've not learned to put her in some definite place as you do.
This is what you meant when you mentioned that you hold a patient firmly to her task.

Relating Conscious and Unconscious


It is very important for her to develop a specific hallucination
and to retain it
and be able to describe it.
(Pause)
E: It is very important that she do something specific here. It is important that she does
something, something "specific." And for heavens sake, what is it?
R: Oh, I see, you are readying her for work now. She thinks, "I've got some important
work to do. Okay, but what is it?"
E: That's right. Making her increasingly more interested in the work she will now do.
R: Is there a paradox here? In the induction the purpose was to dissociate her
conscious mind so it would not interfere, yet here you are instructing it. Are you
focusing the conscious on the unconscious?
E: No, the conscious mind is to give full cooperation to the unconscious. You're feeding
it to the unconscious.
R: You have gathered up all her conscious awareness and are giving its energy to the
unconscious?
E: Yes.
(Erickson now describes one of his current cases, where the patient's conscious mind
is not yet ready to handle certain insights that are being formulated in the unconscious.
The patient is producing symbolic drawings and writings that his conscious mind
cannot yet understand.)

Trance Learning by Association


[Here Erickson gives a detailed 20-minute case history of a former patient who painted
a landscape he saw in hypnotic trance and the relevance of this landscape for his
personal dynamics. He appears to be talking to R. The subject sits quietly, apparently
going deeper into trance.]
What happens in creating a hallucination related to the past?
A scene of S as a little girl
enjoying something she long ago forgot.
(Pause)
And I would like that scene to come into being,
be real.
And I want S to begin that scene,
feeling, sensing, thinking
as that situation was years ago.
And there will be no memory
of the intervening years since then.
So S can be a little girl
happily playing
something long forgotten.

And now you can regress


and enter into that.
(Pause)
[At this time S's children were actually playing outside the office in Erickson's
backyard so we inside could hear their laughter and the faint hubbub of their voices].
R: You give these case histories while the patient is in a trance so they can learn by
association; they learn to identify vicariously with that case history, and they tend to do
similar things.
E: Yes. She had some age regression there in which she had some fantasies of her
childhood and some of the wishes of her adult life and some of its realities.

Therapist's Voice in Patient's Inner Experience


In my voice you can hear
the whispering wind,
the rustle of leaves.
(Pause)
And then my voice becomes that of some neighbor,
adult friend, relative, someone known.
R: Here you merge your voice with her inner experience.
E: That's right. How do you merge your voice with a patient's inner experience? You
use words that ordinary life has taught you: "the whispering wind." We have all had
whispering experiences.
R: So that puts you into associative contact with something whispering and close.
E: And close:
E: I'm not asking her to do anything she doesn't want to. It could be a friend, relative,
anyone known.

Recovering Forgotten Memories:


Time Distortion
You will in due course say something
Long forgotten
now remembered.
(Pause)
A very happy memory.
And then the next year you will remember,
and the year after that,
and the year after that,
and time is passing rapidly
E: When is "in due course"?
R: It could be any time.
E: That's right.
R: You are trying to lift a specific amnesia here? You're making an effort to have her
recover forgotten memories?
E: Yes.
R: With that last phrase you are adding the possibility of time distortion?
E: Yes.

Ratifying Age Regression


and you are growing
(Pause)
becoming a big girl.
E: This ratifies the regression because she can only be big now if she was little earlier.
R: Even if it was only for a fraction of a second, a mere flash of an early memory, she is
now ratifying it, no matter how much or how little there was.

Focusing and Accompanying the Patient:


Words with General and Specific Significance
And someday you will meet some stranger
and you will be able to tell him about it.
And when you meet that stranger,
you will tell him
about the beautiful landscape.
E: Every women has a past in which she wanted to meet a stranger.
R: You are picking up a specific motivation there.
E: But you have not defined it, you are still letting her make her own definition of it.
R: You are tapping into a very intimate channel of her mind, not just a banal or general
reality. It is a general reality you know every woman has had, and yet each woman has
a specific experience with a stranger. You're safe in suggesting a general category, a
stranger, but it will elicit a specific memory in every woman.
E: There is a general problem for the beginning therapist here. You start patients in a
train of association, but they drift along their own currents of thought and frequently
leave the therapist stranded far back. Then the patient gets furious because the
therapist tries to barge in—in the wrong way. He hasn't used words that allow him to
accompany the patient. To do this, we use words that have both a general and a very
specific personal significance. Every woman wants to meet a stranger in her girlhood,
teenage years, her early adult life. That stranger who would eventually become
someone very specific, her lover, her husband.
R: These words with both a general meaning and specific personal significance allow
you to focus and accompany patients into very personal associations even though you
may not know exactly what they are experiencing.

Ratifying Age Regression


And now in progression come through the years until you reach October 1972.
E: You're asking the patient to progress from time A to B and C. That ratifies that the
years of A through C were real. So in a way you are ratifying the regression.
Contingent Suggestion
And when you get there when you get to the right date
(Pause)
you will arouse
with full memory.
R: When you make arousing from the trance contingent upon reaching the current
date, you are again ratifying that she must have been in the past to progress to the
present to wake up. In general you try to associate your suggestions with any inevitable
behavior that is about to occur. One of your favorite examples is, "Don't enter trance
(suggested behavior) until you sit all the way down in that chair" (inevitable as the
patient approaches the chair). Every mother has said "Shut the door (suggested
behavior) on your way out" (inevitable as Johnny approaches the door).

Dissociation Double Bind for Amnesia


You will realize
hypnosis was employed,
you will not remember going into a trance.
It isn't necessary to remember going into a trance.
(Pause)
R: This appears to be a simple dissociation double bind to facilitate an amnesia. You
dissociate the memory of going into trance from its normal context of "You will realize
hypnosis was employed." You then reinforce the dissociation by remarking, "It is not
necessary to remember going into a trance."

Posthypnotic Suggestion for Amnesia


S: Um. [She reorients to her body by stretching a bit, touching her face, etc.]
E: Do you think you can go in a trance this morning?
S: Humm?
E: Do you think you can go into a trance this morning?
S: Uh, yeah, I guess I did. Do I think I can again?
E: Humm?
S: Yeah, I guess I could.
R: When she asks, "Do I think I can again?" it means that she realizes she was just in a
trance. Therefore, your posthypnotic suggestion that she forget that hypnosis was just
employed failed.
E: Except it did not really fail. — She is just "realizing" the trance. You can realize there
was a yesterday but not exactly what you did yesterday.
R: Amnesia may be present for many things you did yesterday even though you realize
there was a yesterday. So the general category of trance experience is recalled, but
not necessarily the specific contents. She is following your suggestion very literally
when you said in the last section, that she could, "realize hypnosis was employed. . .
you will not remember going into a trance." There is a subtle but very real difference
between "realizing" and "remembering." You do not bother testing the amnesia at this
point because she is still so close to the trance that she could build associative bridges
to it and thus destroy the possibility of fulfilling your suggestion for amnesia.
E: That's right.

Questions to Locate Problems


E: What memories come to mind?
S: Being in Maine, by the ocean, looking at the starfish and things.
E: In Maine?
S: Yeah, and my uncle, a lobster fisherman, told me to get up at 5 the next morning to
go out on the beach with him.
E: All right, now what has happened to you this morning?
S: I guess I went back to that scene when I was 12 years old.
E: How do you mean, you went back?
S: I guess I remembered it.
E: How tall were you?
S: five-one or five-two.
E: Why did you say your uncle?
S: Oh, he didn't talk much. I did wake up the next morning and went with him.
E: Are you awake yet?
R: Why are you asking all these specific questions here?
E: You ask specific questions in therapy when you don't know where the patient's
problem is. I'm exploring I'm opening up many different aspects.
R: I see. Perhaps there was an emotional problem associated with this memory.
E: Yes. If there is a problem here, some of these questions may give her an opportunity
to talk about it. But here she just treats them as straightforward questions.

Amnesia by Distraction
S: [laughs] I, I think so, yes. E: How did you go into a trance this morning? S: Well you
took my hand or something. E: What's the "or something"?
S: Well, I never know what you are doing. Yes, you took my hand and looked at me.
E: Is that the best description you can give?
E: By asking her these questions I'm also facilitating amnesia.
R: How? You mean asking her how she went into trance is a distraction or an
unimportant detail that is going to help her forget what actually happened in trance?
E: Yes. It's a distraction. When she is so vague as to say "or something," it indicates
her memory is being contracted.
R: When she says, "I never know what you are doing," she is admitting the success of
your confusion approach and the way it limits her conscious awareness.

Fogging Phenomenon
S: Yes, I think so. I'm not familiar with that. I was looking at you but got
embarrassed looking so I looked at the top of your hair. Then it started fogging up.
E: Explain that fogging.
S: Well, it kind of gets foggy. It's cloudy or foggy, not quite in focus. Like it's distant,
like by the ocean it gets foggy. You can't concentrate on a point
any longer------That might have brought back that scene because that looks
like the fog of the ocean.... It was distorted for a minute. Like you could see in that
glass.
[S again points out the irregularly cut glass piece on Erickson's desk which he
frequently uses a fixation point for inducing hypnosis.]
Things are distorted and elongated.
E: What time is it?
S: Unfortunately, I just looked. It is 10 of 11, but it did seem longer.
R: This report of fogging was a classical sign of hypnosis in the older literature and I've
recently learned that gypsies characteristically see fog or clouds in their crystal balls
just before the visions. You have described it as a characteristic of the white
background subjects apparently experience when they have "stopped vision" in deep
trance (Erickson, 1967). What is the meaning of such fogging?
E: Fog comes in when you get away from external reality. It is a way of occluding
reality. It makes you feel all alone just as you feel alone when you walk out on a foggy
day.

Double Bind Question to Initiate Indirect Trance Induction


E: Do you think you're awake yet?
S: Well, I feel slightly distant but I feel basically awake I think, I don't know. Yes I am.
R: She has been awake and now you begin to cast doubt upon her awake state with
this double bind question.
E: That's right.
R: The "distant" feeling she immediately describes is, of course, the first indication that
another trance is beginning.
E: Going into trance is like "going away" because you are going distant from external
reality.

Hand Levitation Induction:


Dissociation by Implication
E: Now direct your attention to your right hand.
(Pause)
Your right hand may have a tendency to move upward.
(Pause)
It begins to quiver and move up
toward your face.
[S's arm does begin to levitate to her face.]
(Pause)
When your hand touches your face, you can take a deep breath,
and go deeply asleep,
and be unable to lower your hand.
E: You see. she is looking at a hand. Where is the rest of her?
R: The implication is that she has lost the rest of her body. So this is effecting a
dissociation, and a dissociation is a characteristic of trance. So as soon as this begins
to take place, you've got a trance.
E: But you are not laboriously saying, "Cease to see the rest of your body."
R: Which would only arouse the typical response, "I can't". You give suggestions for
dissociation by implication.

Suggestions Covering All Possibilities of a Class of Responses:


Utilizing Subjective Experiences
Your arm will feel entirely comfortable,
at ease,
or it may lose all feeling,
or it may develop a wooden feeling,
a feeling of not being your arm.
I'd like to have you interested in discovering your way of handling that arm. [pause as
S's hand levitates to her face.]
R: Here you give her many possible options about what her subjective experience may
be as she holds her hand by her face. This allows her to utilize whatever subjective
means she has to implement your suggestion. You facilitate a direct suggestion, as "be
unable to lower your hand," by covering (or appearing to cover) all possibilities of
subjective experience to support it. You substitute an interesting piece of self-
exploration for what might otherwise be a boring or tedious task.

Catalepsy:
Implication and Indirect Suggestion for Exploring Human Potentials
Of course
something has happened to your left hand,
and that will remain,
and when you awaken
you will have lost
all control of your right arm,
(Pause)
And I want you to be curious
about that dissociation of your right arm.—
the nature and character of it—
because everybody handles the situation slightly differently.
(Pause)
Your arm will remain immobile.
R: Did you notice something happening to her left hand, or was that an indirect
suggestion?
E: I'm really telling her, "Let something happen to your left hand." The implication is that
it will imitate the right hand. The implication is also present that she doesn't know
what's happened to her left hand.
R: This indirect way of giving suggestions deepens trance.
E: It always deepens trance. S offers me the handicap of intellectual desire to keep her
knowledge available for use with her own patients.
R: That's a handicap because you'd rather not have her consciousness so active. You
would rather see how her individual differences are manifest in a spontaneous manner.
E: She's got to find out her differences and she can't dispute them.
R: This is fascinating! You use implication as an indirect form of suggestion to set
behavior in motion that will help her explore her own individual differences in dealing
with the situation. You are really not manipulating and controlling her. Rather, you are
offering suggestions in such a way that her own unique response potentials become
manifest in a manner that can be surprising and informative to both of you. Even while
immobilizing her arm in what might appear to be a conventional catalepsy, you are
actually leaving room for the exploration of human potentials. It is actually the
subjective process by which she immobilizes her arm that will reveal whether she has a
latent talent for anesthesia ("it may loose all feeling"), comfort, rigidity, ideosensory
responses ("wooden feeling"), or whatever.

Posthypnotic Suggestion Contingent on Awakening


And I can count backward from 20 to 1 in any way I wish.
At the count of one you will awaken, but your arm won't.
(Pause)
20, 15, 10, 5, 4, 3, 2, 1.
R: You frequently associate awakening with a posthypnotic suggestion. This is another
form of contingent suggestion in which the inevitable behavior of awakening is made
contingent on the posthypnotic suggestion that "your arm won't [awaken].

Posthypnotic Analgesia from Two Mutually Reinforcing Suggestions


S: Humm. [laughs as she notices her right hand immobile by her face. She reaches up
with her left hand and rubs the back of her right hand.]
E: Why did you rub it?
S: Because it feels numb.
R: It is easy to miss this "numbness" or analgesia that is unobtrusively indicated by the
casual way she rubs the back of her hand. Your question about it brings the admission
that it is actually numb. She is thus following a very casual suggestion for a possible
analgesia you administered earlier in your "suggestions covering all possibilities of a
class of responses." This posthypnotic analgesia is also a consequence of the
dissociation implied in the awakening suggestions you just gave, "At the count of one
you will awaken but your arm won't." This is an excellent example of how you can
administer two or more mutually reinforcing suggestions to reinforce one process.

Questions for Indirect Trance Induction


E: Now what's happening to your left arm?
S: Right arm is still stiff.
E: Something is happening to your left hand.
S: [laughs as she notices her left hand getting a bit stiff and immobile.]
R: She is apparently awake at this point, but when you ask this question, is it indirectly
inducing another trance?
E: Yes.
R: This seems to be an excellent way of inducing a trance in an indirect manner so that
S does not even recognize a trance is being induced. You simply ask an innocent
question about what's happening to her left arm. In response she cannot help but focus
her attention on that arm. Your question is actually an implied suggestion that
something will happen, and when something does happen (whether its a movement, an
awareness of a sensation, or whatever), that something announces the beginning of a
dissociation (because it appears to happen by itself without the subject's conscious
volition), and dissociation, of course, is a major feature of trance experience.
E: And the subject takes credit for it. You're not telling the subject to "do this, do that."
So many therapists tell their patients how to think and how to feel. That is awfully
wrong.
R: It is more effective to induce the trance in a way the patient can take credit for.

Surprise to Reinforce Trance


E: It takes you by surprise?
S: It does feel a bit tingly.
E: This question is also a statement.
R: You reinforce "surprise" and by implication a state of confusion, so you—
E: reinforce the trance!

Compound Suggestion for Dissociation


E: It's going to happen, and you'll have no control over what happens.
S: I don't remember your telling me anything about it, so I don't know what's going to
happen.
[Notices how left hand is getting stiffer in a midair pose]
E: [To R] You may have an idea of what's happening. [It was gradually becoming
evident that her left hand was becoming immobile.]
R: This is a compound suggestion that is very typical of your style. The truism in the
first part, "It's going to happen," opens a yes set that tends to facilitate acceptance of
your strongly directive suggestion in the second part, "You'll have no control over what
happens." The casual way you said this was so disarming that at the time I did not
even recognize that you were making a strong suggestion for dissociation.
Catalepsy and Analgesia
S: Well, it feels a little strange, like my hand feels it is falling asleep or something. I'm
not sure myself, but my left hand is getting a little numb too.
E: Now try to discover what is happening so you can define what is happening to that
hand.
S: Well, it feels a little numb.
E: Something else is happening. S: Well, its moving a little too.
E: [To Rossi] Actually, of course, its moving around is a form of resistance at this
time.
(Pause)
R: Your suggestion that she will have "no control over what happens" initiates a
process of confusion and finally a catalepsy and an associated anesthesia.
E: The aside (to R) at the end is actually an indirect suggestion that something is
happening.
R: I see. Your remarks to me are actually indirect suggestions to her.

Catalepsy as a Segmentation Phenomenon


You can discover what's happening to your arm through your elbow and then through
your wrist.
(Pause)
You see what has happened.
First there was extreme mobility in the entire left arm,
and then less at the elbow,
and then finally growing immobility down to the wrist,
and then finally the fingers.
So your arm got fixed bit by bit.
(Pause)
Now what do you suppose is the next thing you will do?
E: Patients all have their own patterns of experiencing hypnotic phenomenon in a
segmental manner. It is not important that she knows how she does it, but this sort of
description allows me to stay with her. Staying with your patient is so important.
R: So this was an indirect trance induction by simply suggesting that something was
happening to her left arm. What you found happening was a gradually spreading
immobility (catalepsy) and numbness (anesthesia.) These responses are a highly
individual matter, and much of the skill of the therapist is in discovering their
spontaneous manifestation. Having established those hypnotic phenomena, you end
by asking another question, "what do you suppose is the next thing you will do?" That
question sets the stage for another open-ended exploration of whatever other hypnotic
phenomena she may be ready to experience.

Question Initiating Dissociation


Can you figure it out?
S: I feel a little odd at this point
E: You (R) are probably aware of what's going to happen.
(To S) Of course, you are aware that you are not fully awake.
E: If she's got to "figure it out," that affirms that something is happening.
R: She responds to your question with further dissociation indicated by the "odd"
feeling.
R: These two statements catapult her into trance by fostering doubt about her mental
state.
E: Yes.

Contingent Suggestion
S: Would it be all right if I put my arm down?
E: Then your eyes will shut.
(Pause)
R: This is another contingent suggestion: you associate your suggested behavior ("your
eyes will shut") with an inevitable behavior that is about to occur (putting her arm
down). Your suggestion rides piggyback on the patient's own motivation. You utilize her
wish to do one thing to have her accept another suggestion that will maintain trance.

Trance Termination and Ratification


I want your arms to be very comfortable,
and then you can awaken comfortably,
and you can awaken only after you open your eyes.
[To R] And no matter what the trance state is, when they have had their eyes open,
you have them close their eyes first and then open them to awaken. That comes from
a lifetime of experience.
(S awakens and reorients to her body by stretching a bit, touching her face, patting
her hair, adjusting her skirt.)
E: And how do you feel now?
S: Fine.
E: Tired?
S: No, fine.
E: Now while awake, hold your arm up in that same awkward position and see how
tired it gets.
(S holds her arm up and soon acknowledges that it is getting tired.)
E: You have them close their eyes because there is a whole lifetime of experience of
having their eyes closed before they awaken.
R: Again you utilize a habitual built-in mechanism for your own purpose. What
experiences have you had here? Has anyone ever left your office in trance? How long
have you kept people in trance?
E: People have gone out of the office and then walked back in and said, "You'd better
awaken me." (Dr. Erickson now recounts a few instances where he allowed especially
competent hypnotic subjects to remain in trance for as long as they required to solve a
particular problem—in one case for two weeks. They would go about their normal
everyday activity without anyone detecting their trance state. The purpose of the trance
was to enable them to continuously work out some inner problem.)
R: You ratify the trance by having her "while awake, hold your arm up in that same
awkward position and see how tired it gets." This, of course, is an instruction that
contains a strong suggestion that her hand will get tired. Since the hand gets tired more
rapidly when awake, that ratifies she must have been in a trance earlier.

CONFUSION IN THE DYNAMICS OF TRANCE INDUCTION


R: You said earlier that in almost all your induction techniques, confusion is something
that breaks up their reality orientation. It breaks their tie to normal awakeness?
E: Yes. You know, ordinarily, what is what about yourself and the other person. When
confused, you suddenly become concerned about who you are and the other person seems
to be fading.
R: Confusion is an opening wedge to trance?
E: Yes. If you are uncertain about yourself, you can't be certain about anything else.
R: Actually they are getting a lot of their reality sense from you and if you throw doubt
into them?
E: It spills over into their doubt about all reality. If you are uncertain about something, you
tend to avoid it.
R: I see! They start withdrawing from reality if they are uncertain about it.
E: That's right! They don't know what it [reality] is.
R: If you then add to that the suggestion of a pleasant inner reality, they'd rather go to it.
E: Anything is better than that state of doubt.
R: Especially if you are up in front of an audience with everyone looking at you.
E: You want to get out of that situation, but there is no place except trance.
R: That is why hypnosis works so well in front of an audience. That is where the stage
hypnotist gets a lot of his leverage.
E: Yes. He merely capitalizes on that, and he makes it deliberately unpleasant by his
aggressive manner and the various tricks he employs. They will do anything to escape from
that. (Erickson gives examples of how he created unpleasant situations to catapult patients
into trance. Some of these are outlined in Rossi's 1973 paper, "Psychological Shocks and
Creative Moments in Psychotherapy.")
R: So this confusion is the basis of many of your nonverbal pantomime techniques,
would you say?
E: That's right.
R: It is the basis of staring or looking through the subject. These are all ways of
disconcerting the subject, ways of making them have doubts about themselves.
E: They begin to wonder but they don't know what they are wondering about. That is very
confusing!
R: Even in something as simple as eye fixation: you focus on that spot, but if you keep
focusing on that spot, sooner or later your eyes are going to get tired, you are going to get
blurred vision. All these things induce confusion.
E: That's right.
R: So confusion really is at the basis of all induction techniques?
E: It is the basis of all good techniques. Just as in something as simple as closing the
eyes. Most workers in hypnosis do not know that as the subject closes the eyes, the subject
is cutting off the visual field and is really losing something but he doesn't know what he is
losing. He thinks he is just closing his eyes.
R: There are many things happening when we close our eyes, many realities we must
give up.
E: In focusing on a spot you automatically cut down on peripheral vision. Then the spot
gets larger as it occupies all the field of vision. You know a spot can't get larger, yet it does!
R: So that is again distorting reality and throwing them into confusion.
E: They don't know what to do. So then the therapist can tell them what to do. He lays
out the ground for the subject to traverse, review, organize.
R: So can we make a summary statement that the basis of good hypnotic induction is
confusion?
E: Confusion about the surrounding reality which in ordinary life is always clear. If the
surrounding reality becomes unclear, they want it cleared up by being told something (e.g., I
don't know where I am in this city: where am I? I don't recognize this place: what is it?).
R: That automatically tends to promote a regression, incidently. It associates them to the
time when they were children and asked such questions.
E: That's right! And you are not demanding it, but you are eliciting a receptive attitude,
and your most innocent question can be interpreted by them. If you know how to ask
questions, you ask them in such a fashion that they will pick out the thing you want.
R: So confusion is the most basic phenomenon of induction?
E: We'll call it: The dimming of outer reality. When outer reality becomes dimmed, you
get confused.
R: So we can summarize the dynamics of induction with a flow diagram:
1. Dimming of outer Reality

2. Confusion

3. Receptivity for Clarifying Suggestions

4. Trance Work Proper

DYNAMICS OF THE HANDSHAKE INDUCTION


The handshake induction is one of the most fascinating and effective procedures
developed by Erickson for initiating trance. It is essentially a surprise that interrupts a
subject's habitual framework to initiate a momentary confusion. A receptivity for clarifying
suggestions is thus initiated with an expectancy for further stimuli and direction. In a letter to
Weitzenhoffer in 1961 Erickson described his approach to the handshake induction as a
means of initiating catalepsy. When he released the subject's hand, it would remain fixed in a
cataleptic position or would keep moving in any direction he initiated. He used this approach
as a test to assess hypnotic susceptibility and as an induction procedure. The prerequisites
for a successful handshake induction are a willingness on the part of the subject to be
approached, an appropriate situation, and the suitability of the situation for a continuation of
the experience. An edited version of his outline of the whole process and some variations is
as follows.

The Handshake Induction


Initiation: When I begin by shaking hands, I do so normally. The "hypnotic touch" then
begins when I let loose. The letting loose becomes transformed from a firm grip into a gentle
touch by the thumb, a lingering drawing away of the little finger, a faint brushing of the
subject's hand with the middle finger — just enough vague sensation to attract the attention.
As the subject gives attention to the touch of your thumb, you shift to a touch with your little
finger. As your subject's attention follows that, you shift to a touch with your middle finger and
then again to the thumb.
This arousal of attention is merely an arousal without constituting a stimulus for a
response.
The subject's withdrawal from the handshake is arrested by this attention arousal, which
establishes a waiting set, an expectancy.
Then almost, but not quite simultaneously (to ensure separate neural recognition), you
touch the undersurface of the hand (wrist) so gently that it barely suggests an upward push.
This is followed by a similar utterly slight downward touch, and then I sever contact so gently
that the subject does not know exactly when—and the subject's hand is left going neither up
nor down, but cataleptic. Sometimes I give a lateral and medial touch so that the hand is
even more rigidly cataleptic.
Termination: If you don't want your subjects to know what you are doing, you simply
distract their attention, usually by some appropriate remark, and casually terminate.
Sometimes they remark, "What did you say? I got absentminded there for a moment and
wasn't paying attention to anything." This is slightly distressing to the subjects and indicative
of the fact that their attention was so focused and fixated on the peculiar hand stimuli that
they were momentarily entranced so they did not hear what was said.
Utilization: Any utilization leads to increasing trance depth. All utilization should proceed
as a continuation or extension of the initial procedure. Much can be done nonverbally. For
example, if any subjects are just looking blankly at me, I may slowly shift my gaze downward,
causing them to look at their hand, which I touch as if to say, "Look at this spot." This
intensifies the trance state. Then, whether the subjects are looking at you or at their hand or
just staring blankly, you can use your left hand to touch their elevated right hand from above
or the side—so long as you merely give the suggestion of downward movement.
Occasionally a downward nudge or push is required. If a strong push or nudge is required,
check for anesthesia.
There are several colleagues who won't shake hands with me, unless I reassure them
first, because they developed a profound glove anaesthesia when I used this procedure on
them. I shook hands with them, looked them in the eyes, slowly yet rapidly immobilized my
facial expression, and then focused my eyes on a spot far behind them. I then slowly and
imperceptibly removed my hand from theirs and slowly moved to one side out of their direct
line of vision. I have had it described variously, but the following is one of the most graphic. "I
had heard about you and I wanted to meet you and you looked so interested and you shook
hands so warmly. All of a sudden my arm was gone and your face changed and got so far
away. Then the left side of your head began to disappear, and I could see only the right side
of your face until that slowly vanished also." At that moment the subject's eyes were fixed
straight ahead, so that when I moved to the left out of his line of vision, the left side of my
face "disappeared" first and then the right side also. "Your face slowly came back, you came
close and smiled and said you would like to use me Saturday afternoon. Then I noticed my
hand and asked you about it because I couldn't feel my whole arm. You just said to keep it
that way just a little while for the experience."
You give that elevated right hand (now cataleptic in the handshake position) the
suggestion of a downward movement with a light touch. At the same time, with your other
hand, you give a gentle touch indicating an upward movement for the subject's left hand.
Then you have his left hand lifting, right hand lowering. When right hand reaches the lap, it
will stop. The upward course of the left hand may stop or it may continue. I am likely to give it
another touch and direct it toward the face so that some part will touch one eye. That effects
eye closure and is very effective in inducing a deep trance without a single word having been
spoken.
There are other nonverbal suggestions. For example, what if my subject makes no
response to my efforts with his right hand and the situation looks hopeless? If he is not
looking at my face, my slow, gentle out-of-keeping-with-the-situation movements (remember:
out-of-keeping) compel him to look at my face. I freeze my expression, refocus my gaze, and
by slow head movements direct his gaze to his left hand toward which my right hand is
slowly, apparently purposelessly moving. As my right hand touches his left with a slight,
gentle, upward movement, my left hand with very gentle firmness, just barely enough,
presses down on his right hand for a moment until it moves. Thus, I confirm and reaffirm the
downward movement of his right hand, a suggestion he accepts along with the tactile
suggestion of left hand levitation. This upward movement is augmented by the facts that he
has been breathing in time with me and that my right hand gives his left hand that upward
touch at the moment when he is beginning an inspiration. This is further reinforced by
whatever peripheral vision he has that notes the upward movement of my body as I inhale
and as I slowly lift my body and head up and backward, when I give his left hand that upward
touch."
Erickson's description of his handshake induction is a bit breathtaking to the beginner.
How does one keep all of that in mind? How does one develop such a gentle touch and such
skill? Above all, how does one learn to utilize whatever happens in the situation as a means
of further focusing the subject's attention and inner involvement so that trance develops?
Obviously a certain amount of dedication and patience are required to develop such skill. It is
much more than a matter of simply shaking hands in a certain way. Shaking hands is simply
a context in which Erickson makes contact with a person. He then utilizes this context to fix
attention inward and so set the situation for the possible development of trance.
As he shakes hands, Erickson is himself fully focused on where the subject's attention is.
Initially the subjects' attention is on a conventional social encounter. Then, with the
unexpected touches as their hand is released, there is a momentary confusion and their
attention is rapidly focused on his hand. At this point "resistant" subjects might rapidly
withdraw their hand and end the situation. Subjects who are ready to experience trance will
be curious about what is happening. Their attention is fixed and they remain open and ready
for further directing stimuli. The directing touches are so gentle and unusual that subjects'
cognition has no way of evaluating them; the subjects have been given a rapid series of
nonverbal cues to keep their hand fixed in one position (see last paragraph of the initiation),
but they are not aware of it. Their hand responds to the directing touches for immobility, but
they do not know why. It is simply a case of an automatic response on a kinesthetic level that
initially defies conscious analysis because the subjects have had no previous experience
with it. The directing touches for movement are responded to on the same level with a similar
gap in awareness and understanding.
The subjects find themselves responding in an unusual way without knowing why. Their
attention is now directed inward in an intense search for an answer or for some orientation.
This inner direction and search is the basic nature of "trance." Subjects may become so
preoccupied in their inner search that the usual sensory-perceptual processes of our normal
reality orientation are momentarily suspended. The subjects may then experience an
anesthesia, a lacuna in vision or audition, a time distortion, a deja vu, a sense of
disorientation or vertigo, and so on. At this moment the subjects are open for further verbal or
nonverbal suggestions that can intensify the inner search (trance) in one direction or another.

Exercises in the Nonverbal Approaches


1. The keys to learning nonverbal approaches to trance induction are observation,
patience, and learning one step at a time. One can begin learning the handshake induction
by developing a habit of carefully observing a person's eyes and face as you are shaking
hands with them in a normal way. The next stage might be to practice releasing the hand a
bit slower then usual. Then learn how to definitely hesitate in releasing the hand, carefully
watching the subject's face to "read" the nonverbal responses (e.g., confusion, expectancy)
to your hesitation. As your experience develops, even at this level you will begin to recognize
who may be a good subject by the degree receptivity to your hesitation. The subject who
"stays with you" and allows you to set the pace of the handshake is evidently more sensitive
and responsive than the person who rushes off.
The next step might be only to release the hand halfway, so the subject is momentarily
confused. You can then practice letting go of the rest of the hand so gently that the subject
does not recognize when the release took place, the hand remaining momentarily suspended
in midair. You can sometimes heighten this effect by speaking very softly so the subject's
attention is further divided in trying to attend to you. The final stage is learning to add the
directing touches as non-verbal stimuli for immobility (catalepsy) or movement (hand
levitation). Sacerdote (1970) had described and analyzed a similar procedure for inducing
catalepsy in a non-verbal manner.
2. What other non-verbal touch situations of everyday life can you learn to utilize to fix
and focus attention inward to initiate trance?

COMPOUND SUGGESTIONS

I. The Paradigms of Acceptance Set, Reinforcement, or


Symbolic Logic
A surprisingly simple aspect of Erickson's approach is his use of compound suggestions.
The compound suggestion in its simplest form is made up of two statements connected with
an "and" or a slight pause. One statement is typically an obvious truism that initiates an
accepting or "yes set", the other statement is the suggestion proper. In this session, for
example, when Dr. S was beginning to feel her arm getting stiff, immobile, and "tingly,"
Erickson reinforced the tendency toward dissociation with a compound suggestion:
E: It is going to happen
R: This is the first statement of an obvious truism since it is in fact happening as Dr. S
herself demonstrates and describes.
E: and
R: The conjunctive "and" connects the two statements.
E: You'll have no control over what happens.
R: The second statement contains the suggestion proper that will reinforce her current
experience of dissociation.
A much more complex compound suggestion with many implications is in the last
statement Erickson makes in this session.
E: Now while awake
R: This strongly indicates that trance has terminated and reinforces her state of
awakeness. Since she really knows trance has terminated, this is also a truism that
opens her for what follows.
E: hold your arm in that same awkward position
R: The word "hold" implies she must make an effort, and "awkward" implies it will be
difficult. This strongly sets up the likelihood that the suggestion proper, which follows,
will actually happen.
E: and
R: The conjunctive "and" associates the following suggestion with the previous truisms
(that she is awake and can hold her arm in that awkward position).
E: see how tired it gets.
R: The suggestion proper. Naturally she quickly acknowledges that her arm is tired,
thus ratifying that the trance condition was different from the awake state. This also
contains the implication that one can do different things in trance.
Other examples of compound statements are as follows.
E: Just look at one spot and I'm going to talk to you.
R: In this example the therapist has control over his own behavior ("I'm going to talk to
you"), and by simply talking he can actually reinforce the suggestion, "Look at one
spot."
E: There's nothing that is really important except the activity of the unconscious mind
and that can be whatever your unconscious mind desires.
R: The importance of unconscious activity is suggested and then reinforced by an
obvious truism of its independent activity.
E: We know the unconscious can dream and you can easily forget that dream.
R: This indirect suggestion to dream is itself a scientific truism. It is further reinforced by
the truism that one can forget a dream. Merely mentioning, "You can easily forget," is
also an indirect suggestion for amnesia.
E: You have altered your rate of breathing, your pulse, and your blood pressure.
Without knowing it you art demonstrating the immobility that a good hypnotic subject
can show.
R: After an initial period of trance induction, when a subject is in fact very quiet, this
statement about altered body functioning is a truism opening a yes or acceptance set
that permits the therapist to indirectly suggest "you are ... a good hypnotic subject."
R: You can continue enjoying relaxing comfortably for a few moments and after you
awaken you can relate one or two things you are willing to share, and you can let the
rest remain within the unconscious where it can continue its constructive work.
R: At the end of a satisfactory hypnotherapeutic session the reward of "relaxing
comfort" tends to reinforce all that happened previously while opening an acceptance
set for the posthypnotic suggestion to both recall and forget. "You can let the rest
remain in the unconscious" is an indirect suggestion for amnesia, permitting the
unconscious to continue therapy on its own, free from the limiting and biasing influence
of both the therapist's and patient's conscious sets.
It is clear from these examples that compound statements consist of two parts:
1. A truism consisting of an acceptable fact that can establish an acceptance set for
the suggestion or reinforce it. If the truism has motivating properties for the patient, it is
even more effective.
2. A suggestion proper that can appear before or after the truism. When the truism
comes before the suggestion in a compound statement, it initiates a yes or acceptance set
for the suggestion that follows. When the truism follows the suggestion in a compound
statement, the truism is in a position to function as a reinforcer of the suggestion. As can be
seen from the above examples, Erickson uses both forms. It will be a matter of future
research to determine if both forms are equally effective. If they are, it would indicate that the
commutative law (wherein the positions of the truism and suggestion may be reversed), so
common in symbolic logic, may also apply to our usage of compound statements. This would
imply that these hypnotic forms follow the types of laws found in symbolic logic (Henle,
1962). If it is found that the reinforcement form (wherein the truism follows the suggestion) is
more effective, then it would appear that the classical laws of learning theory are more
appropriate for our understanding of compound statements in hypnosis. If it is found that the
acceptance set form (wherein the truism precedes the suggestion) is more effective, then it
would be evidence that positive expectancy, deemed so important by Erickson, is in fact the
more significant factor in hypnotic suggestion.

COMPOUND STATEMENTS

2. The Paradigm of Shock and Creative Moments


Another provocative and interesting form of compound suggestion utilizes a model of
shock and its resultant creative moment (Rossi, 1973), during which an unconscious search
is initiated within the patient's associative processes. (Erickson and Rossi, 1975). A few
examples are as follows.
E: Now the first step, of course, is to untangle your legs
(Pause)
and
untangle your hands.
R: Erickson initiated hypnosis with an attractive but rigid woman with this casually
offered statement that is subtly shocking because of the sexual implications of
"untangle your legs." The pause allows the shock to set in and initiate a creative
moment with its rapid array of indistinct, confusing, and half-formulated questions
which evoke a high level of added unconscious activity searching for the "correct"
implication. The second half, "untangle your hands," makes the above sex shock
retroactively acceptable. The sexual allusion is now rationalized as something that was
not really intended. The shock effect, however, remains in force on an unconscious
level. Mentioning "untangle" a second time now shunts the high level of mental activity
initiated by the sex shock into other associative networks and pathways to "untangle"
and open more exploratory sets on many levels.
E: I can listen to the whispering
(Pause)
of the wind in the woods.
R. There can be a shock reaction to the word "whispering," which, of course, has many
implications on many levels (secrets, sex, etc.). The pause allows the shock and a
creative moment to initiate a high level of unconscious search. The "wind in the woods"
then makes the above innocuous while developing a poetic mood for allegorical work
evocative of daydream, fantasy, and other trance-oriented activity.
E: Secrets, feelings, behavior, etc. you would rather not talk about (Pause)
can be examined privately and objectively in your own mind in your own trance
(Pause)
for help with the problem at hand.
R: "Secrets" is another shock word, initiating a creative moment within the safety of
trance. The pause allows the shock and inner search for highly emotional memories to
be activated. The potentially disturbing memories are then made relatively safe by now
defining the situation as a "private" and "objective" evaluation. Another pause allows
this safe investigation to proceed. Further positive reinforcement is then added with the
final phrase assuring that this activity will "help with the problem at hand."
In these examples a pause is the critical element, allowing a creative moment to develop
in response to the first shock portion of the compound statement. This first shock portion of
the hypnotic suggestion is obviously most useful for initiating a high level of mental activity
and search that can then be discharged into the associative networks opened by the second
portion. In effect, then, this form of suggestion allows one to initiate a high level of mental
activity and then focus it in a predetermined manner on a problem area.

Exercises in Compound Suggestions


1. In this section we have introduced an approach for analysing compound suggestions.
It can be seen that much fundamental research needs to be done to determine whether
compound statements function according to the paradigms of acceptance set, learning
theory, or symbolic logic (or all three!). The researcher can explore these questions by
designing and executing controlled studies to study the relative effectiveness of these
paradigms. The clinically oriented reader can explore this question by constructing both types
of compound suggestions for use in workshop practice to facilitate the acceptance of
suggestions. It may be found that some clinicians are more effective with one form or another
as a function of their personal style of verbalization, voice dynamics, and other
characteristics.
2. Review tape recordings of therapy sessions to study the natural compounds in the
patient's and therapist's speech. As a patient describes a personal problem, study his
compounds to gain insights into the association patterns that give rise to complexes,
symptoms, and so on. As the therapist talks to a patient, what patterns of ideation and
behavior are being consciously or unconsciously reinforced by the natural compounds in his
speech?
3. Construct hypnotic inductions designed to associate suggestions with truisms that are
particularly acceptable to individual patients. Plan how the various hypnotic phenomena can
also be associated with such truisms in compound statements that are easy to accept.

CONTINGENT SUGGESTIONS AND ASSOCIATIONAL


NETWORKS
Another form of compound suggestion is used when Erickson arranges conditions such
that a patient's normal flow of voluntary responses is made contingent on the execution of a
hypnotic suggestion (the "contingent" suggestion). A hypnotic response that may be low in a
patient's behavioral hierarchy is associated with a pattern of responses high on the patient's
behavioral repertory and usually already in the process of taking place. Patients find that the
momentum of ongoing behavior is too difficult to stop so they simply add the hypnotic
suggestion as an acceptable conditional for the completion of the pattern of behavior that is
already begun and pressing for completion. The contingent suggestion simply "hitchhikes"
onto patients' ongoing flow of behavior. Responses that are inevitable and most likely to
occur are made contingent on the execution of the hypnotic response. Erickson thus
interlaces his suggestions into the patient's natural flow of responses in a way that causes
hardy a ripple of demur.
The simplest form of contingent suggestion may be mother's injunction, "Shut the door
on your way out!" as Johnny is running out the door. The already occurring flow of behavior,
"on your way out" is made contingent upon "shut the door," since the mother is actually
implying, "You can't go out unless you shut the door." Other examples used to systematically
deepen trance are as follows:
Your eyes will get tired and close all by themselves as you continue looking at that
spot.

You will find yourself becoming more relaxed and comfortable as you continue
sitting there with your eyes closed.

As you feel that deepening comfort you recognize you don't have to move, talk, or
let anything bother you.

As the rest of your body maintains that immobility so characteristic of a good


hypnotic subject, your right hand will move the pencil across the page, writing
automatically something you would like to experience in trance.
Associating suggestions in such interlocking chains creates a network of mutually
reinforcing directives that gradually form a new self-consistent inner reality called "trance." It
is the construction of such interlocking networks of associations that gives "body" or
substance to trance as an altered state of consciousness with its own guideposts, rules, and
"reality."
A more complex form of contingent suggestion is in the example Erickson has used on
numerous occasions in front of large groups with a subject he was inducing trance in for the
first time as well as in private practice with patients who were well trained in trance. As the
person approached his chair Erickson would say: "Don't enter trance until you sit all the way
down in that chair, there."
Don't enter trance
E: Use of the negative "Don't" to disarm possible resistance against the suggestion to
"enter trance."
until
E: A form of the contingent that now reintroduces the possibility of trance in what may
be a form acceptable to the patient.
you sit all the way down
R: As part of the ongoing flow of inevitable behavior, this establishes a "yes" or
accepting set for the preceding.
in that chair.
R: An acceptable directive that puts another immediate positive valence on all the
preceding.
there.
E: "There" implies that if they do sit in that chair, they are accepting the choice of going
into trance. It is understood that there are other chairs they can sit in and not go into
trance.
This complex contingent suggestion thus follows this general paradigm: A
negative -> a suggestion -> a contingent -> ongoing flow of behavior.
A classical example of an associational network built up of interlocking chains of
contingent suggestions that led to a dramatic experience of visual hallucinations, amnesia,
and posthypnotic suggestion was Erickson's approach to inducing trance in a "resistant"
member of an audience. On one occasion, for example, a dentist urged his wife to volunteer
as a demonstration subject so she could learn to experience trance. She adamantly refused
and even tried to hide in her seat behind a pillar in the auditorium. Erickson spied her and
proceeded as follows:
E: I like volunteers and I also like to pick my volunteers.
R: This compound statement introduces the agreeable word "volunteer" and makes
everyone a potential volunteer.
The one I'd like to pick is the pretty girl wearing the white hat who keeps hiding behind
the pillar.
S: All the way from Colorado Springs my husband urged me to act as a subject. I told
him I didn't want to.
E: Now, notice that you thought you didn't want to.
E: The implication of this remark is to place her not wanting to volunteer into the past
with "thought you didn't want to." This phrase is also a double bind because it contains
another implication: "thought you don't want to" on a conscious level can imply that you
really wanted to on an unconscious level.
And now that you've come out entirely from behind that pillar, you might as well come
all the way to the platform.
R: This is a contingent suggestion where "come all the way up" is hitchhiked onto her
ongoing behavior of coming out from behind the pillar.
S: [As she steps forward] But I don't want to.
E: While you continue to come forward please, don't go into a trance until you sit all
the way down in this chair.
E: Another contingent suggestion utilizing the negative "don't" to permit a recognition
and expression of her negative attitude while yet defusing it.
As you are on the platform, you know you are not in a deep trance,
E: A truism and a reassurance that she is not in deep trance. This implies she may be
in light or moderate trance.
but you are getting closer to that chair
E: In conjunction with the previous sentence this implies she is going into trance the
closer she gets to the chair.
and you are beginning to recognize you don't care
R: "Beginning" initiates a process of inner search that now utilizes her negative "don't
care" attitude . . .
whether or not you are going into trance.
R: . . .to shift her into the possibility of "you are going into trance."
The closer you get, the more you can recognize the comfort of going into a trance.
R: Another contingent suggestion to which is added the positive motivation of
"comfort."
But don't go all the way in until you sit all the way down in the chair.
R: The classic contingent suggestion described earlier.
All the way down, [said as she is in the process of sitting down]
R: This is a two-level communication; it is a statement with double meaning:(l) Sit "all
the way down" and (2) Go "all the way down" into trance. Her behavior of sitting down
means she is accepting the statement on level 1, but as she sits she is also without
realizing it accepting the suggestion to go into trance on level 2.
E: I associated every one of her forward movements with the development of another
fraction of trance by interlocking every piece of ongoing behavior with another easily
acceptable suggestion.
You are all the way down in the chair all the way from Colorado Springs.
R: In a curious way this implies that every movement from Colorado Springs was an
inexorable movement toward her current trance experience. This deepens the
significance of her trance by giving it a long history.
You knew you did not want to go into a trance. You knew you would prefer something
else. As you think it over
R: A series of three truisms leading up to the following suggestion.
there is something else.
R: A suggestion proper that again puts her on an inner search.
So why don't you look at it?
R: An open-ended question focusing her attention. This is also an indirect suggestion
("Look at") for the possible experience of a visual hallucination.
(Pause)
S: [Looking at a blank wall] I get so much pleasure watching those skiers through my
kitchen window.
R: She responds literally to the above and "watches those skiers" with the "pleasure"
Erickson has suggested a while back.
E: What else enhances it?
R: Another open-ended question that allows her to bring in more personally enhancing
associations.
S: I always keep the hi-fi on while I watch the skiers. That is the easiest way to wash
the dishes.
R: She adds the music that also belongs to her experience. The easiest way to enable
hallucinatory behavior is to evoke the patient's own associations rather than an
arbitrary item.
H: [At this point the husband stands up in the audience and says the following.]
Yes, she washes the dishes while watching the skiers come down the mountainside
by our kitchen window.
[The husband then sends a message up to Erickson expressing the wish that he
would initiate her into hypnotic training for childbirth.]
E: I think you might like to include hypnosis in your future.
R: This is an open-ended suggestion that gives her new options for future behavior.
Suppose you ask me about it after you are awake.
R: This is a posthypnotic suggestion that allows her the possibility of bringing up her
own wishes and needs regarding future hypnotic work. It would be both unethical and
highly destructive of the possibility of future trance work to introduce specific
suggestions about hypnotic training for childbirth without first getting her request for it
when she is awake.
S: [She awakens and looks around the platform.] I told my husband I would not
volunteer as a hypnotic subject!
I was hiding behind that pillar and now I'm here?! I must have been in a trance.
E: Isn't it remarkable how comfortable you feel?
R: A question that is a truism (comfort is characteristic of trance) evokes positive
feelings to depotentiate her reactive anger.
S: What did I do in trance?
R: Implying an amnesia.
E: You would really like to know, wouldn't you?
R: This marshals the memory-traces of her trance experience so they are ready to
enter consciousness.
S: I certainly would!
E: Just look there! [As Erickson looks and points meaningfully at the blank wall she
was looking at when she first hallucinated.]
S: Oh, they are skiing! [She continues actively hallucinating the skiers, describing
their movements.]
R: Her strong motivation is here utilized by providing a channel for experiencing those
memory traces consciously in the form of a visual hallucination with her eyes open,
staring at that same wall. Trance was reinduced by a surprise approach that allowed
the memory traces to discharge in hallucinatory form.
[S is then reawakened with an amnesia for this second trance.]
E: What do you suppose, when you first came up to the platform, you did in that
trance?
S: (S mentions that she probably saw skiers and again repeated all the details about
the skiers as if she had not discussed them before. She then goes on to wonder aloud
if she might not have a use for hypnosis in the future.)
R: She is now following the posthypnotic suggestion about the possibility of including
hypnosis in her future.
E: Well, you are married.
S: Well, I intend to have children. [S then discusses the possibility of utilizing
hypnosis in childbirth. Years later she very successfully did so.]
R: The association about marriage naturally evokes a connection between marriage—
childbirth—hypnosis.

Exercises with Contingent Suggestions


1. The value of observing regularities in patients' behavior which was emphasized in
chapter 1, will now be apparent. The effectiveness of contingent suggestions depends in
great part on their being appropriately timed and associated with regular patterns of ongoing
behavior. The more a patient is "locked into" a certain pattern of behavior, the more powerful
a vehicle will it be for the appropriately hitchhiked suggestion.
Formulate both simple and complex contingent suggestions that you could associate with
any fairly automatic ongoing patterns of everyday behavior you've observed in individual
patients. This can be as simple as encouraging a patient to continue any ongoing pattern of
associations or behavior. Gradually learn how to add modifying suggestions and finally
suggestions to structure further therapeutic responses.
2. Plan how you could utilize simple and complex contingent suggestions for facilitating
psychotherapeutic responses.
3. Construct associational networks that will facilitate hypnotic induction as well as any
particular hypnotic phenomenon. Erickson's work on the construction of artificial complexes
and experimental neurosis (Erickson, 1944) is of particular value for studying his method of
formulating associational networks. The formulation of such associational networks may be
the clearest illustration of the construction of hypnotic realities.

MULTIPLE TASKS AND SERIAL SUGGESTIONS


As we have seen, it is frequently more effective to offer two or more hypnotic
suggestions rather than one. Often the momentum of doing one easy task will help a more
difficult one along—as is the case with contingent suggestions.
A series or chain of interlocking suggestions is another effective method for structuring a
pattern of behavior. The performance of one item serves as a cue and stimulus for the next.
Erickson frequently used such series during the early years of his learning and
experimentation with hypnotic realities. He would have experimental subjects in a laboratory
imagine and "mentally go through the process step by step and in correct order" of reaching
for an imaginary piece of fruit on an imaginary table (Erickson, 1964). If one were actually to
reach out and pick up a piece of real fruit, a series of stimulus-response interactions with the
real objects outside of one's skin would be required. If one performs this task mentally,
however, one is interacting entirely within one's own mind with memories of sensory stimuli,
perceptual patterns, kinesthetic cues, etc. This inner focus and utilization of one's own
mental programs is the essence of trance experience. To put subjects on any sort of mental
task requiring a series of steps utilizing their own internal programs, therefore, is another
valuable hypnotic form.
Because of this Erickson frequently gives serial, multiple, or compound tasks just as he
makes compound statements. His favorite word appears to be "and." "And" allows him to
connect suggestions into series so that they mutually reinforce each other, while at the same
time maintaining the subject within a concentrated inner focus.
The fixing and focusing of attention inward on an imaginary task is thus an indirect
means of inducing trance. This inner trance-inducing focus is easily accomplished by having
subjects review a series of early memories, visualizing a series of scenes or a movie (for
visual types), listening to inner music (especially for those with music training), and so on.
This is the basis for the fantasy and visualization approaches to inducing trance (the "house-
tree-person" or "blackboard" visualizations, etc.)
A chain of casual, naturalistic suggestions forming an associational network is
particularly effective for facilitating posthypnotic behavior. The following example from one of
Erickson's early seminars (Erickson, 1939) is particularly effective because this series of
suggestions about cigarettes is a naturalistic one in the sense that it utilizes typical patterns
of behavior and motivation common to all cigarette smokers. The subject simply floats along
on a natural chain of behavioral events that are already more or less built in.
After awakening the subject would (1) notice Dr. D searching vainly through his pockets
for a package of cigarettes, and (2) the subject would then proffer his own pack, and (3) Dr.
D absentmindedly would forget to return the cigarettes, whereupon the subject would feel
very eager to recover them because he had no others.
The naturalistic or "built-in" aspect of this series of suggestions capitalizes on the
automatic and partially unconscious manner with which habitual behavioral patterns are
carried out. The early stages of trance training are greatly facilitated by utilizing behavioral
patterns that the subject is very familiar with. These require little or no conscious effort and
thus are not likely to interfere with the still fragile nature of early trance experience.

Exercises with Multiple Tasks and Serial Suggestions


1. Formulate hypnotic inductions wherein the subject is kept busy with two or more
tasks. While (1) looking at that spot the subject is enjoined to (2) notice whatever sensations
develop in the eyelids. While (1) watching the hand levitating (2) the unconscious can
marshal all the associations and memories needed to solve a problem.
2. Formulate multiple tasks that are to be carried out on two levels, the conscious and
unconscious, so that double binds become operative.
3. Formulate serial suggestions that lead step by step to the experience of dissociation
and each of the classical hypnotic phenomena.
4. Formulate serial suggestions and associational networks that can facilitate
posthypnotic behavior by utilizing the subject's own natural behavioral patterns.
FOUR

Mutual Trance Induction


One of Erickson's favorite methods of training a hypnotic subject is to give the novice an
opportunity to observe a more experienced subject in trance. But on this occasion Erickson
does something more: he orchestrates a mutual trance induction where two subjects interact
in such a way that they facilitate each others' experience of trance.
In this session Erickson begins by pointing out many of the psycho-physiological
indications of beginning trance. He then has an opportunity to discuss a number of other
outstanding characteristics of trance: patient's subjective feelings of distance; patient's inner
reality and rapport, patient's change in voice quality and learning to speak in trance. The
need for careful and continual observation of the patient is further emphasized when
Erickson outlines the significance of pulsations that can be observed in different parts of the
patient's body. He is particularly careful to note indications of distress in the patient's
behavior. There are various subtle approaches to making inquiries about this distress that will
safeguard the integrity of the patient's inner balance between conscious and unconscious
knowing.
Of particular significance in this session is the clarification of Erickson's view of trance as
an active state of unconscious learning. He points out that it took one of his subjects (a
hospitalized mental patient) 200 hours to get to the point that he was able to do something
more than just sit there. Yet the patient is not expected to direct himself consciously, as is
usually the case when one is awake. The learning is not of the intellectual sort that is
practiced in school. The momentum for this mental activity is to come from the unconscious.
It proceeds autonomously and is experiential rather than intellectual learning. Erickson points
out that most of Dr. S's learning has been of the intellectual sort, but in hypnotic work she
can learn best by letting go and experiencing. Learning spontaneously through one's own
inner experience is then described as another way of deepening trance.

Surprise to Loosen Mental Sets


[As a surprise, Dr. H, a highly experienced hypnotic subject currently in therapy with
Dr. Erickson, was invited to join R and S for this session.]
R: What is the function of surprise in your work?
E: The function of surprise is this. The patient comes to you with a certain mental set,
and they expect you to get into that set. If you surprise them, they let loose of their
mental set and you can frame another mental set for them.
R: You're dislodging the erroneous conscious sets that are giving them problems.
E: Yes. That's also what you do with confusion technique.

Indirect Suggestion
E: Now I'm just going to look at her. I want both of you [R and H] to observe her
blink reflex.
[Pause of 30 sec. as all three watch S.]
E: In talking about S here I am actually giving her indirect suggestions. I here note
many of the criteria of beginning trance as soon as she manifests them in a seemingly
spontaneous manner.
R: This is one of your favorite approaches to indirect suggestion: you say things to an
audience or talk about another person's experience as a way of initiating trains of
associations in the patient that may eventually culminate in hypnotic responsiveness. It
is an indirect form of ideomotor or ideosensory suggestion.

Ideomotor Activity in Indirect Induction:


Beginning Trance Criteria
There was a slight quiver of her eyelids.
Along with that quiver is an ironing out of facial muscles.
There's an alteration in the breathing.
There's also a lowering of blood pressure.
Also a slowing of the heart rate.
There's a loss of reflexes.
She's aware that I am speaking about her to you.
Now there is a slight change in rhythm.
And she's beginning to drift
right into a deep trance state.
E: Everything I say about S is also a suggestion to H, but he did not know it. Every
suggestion I made to S elicits some understanding in H, and that understanding
requires that he act it out for himself to some degree.
R: That is the basic principle of ideomotor activity in hypnosis. You utilize it here to
initiate an hypnotic induction in H without his being aware of it.
(Erickson here describes his typical procedure of demonstrating hypnosis with several
naive subjects in front of an audience. He would surround a resistant subject with
cooperative subjects, demonstrating the various phenomenon until the resistant subject
was influenced by the hypnotic "atmosphere" all around him. The resistant subject
would soon exhibit a "look of surprise" as he began to feel influenced and Erickson
would reinforce this by remarking how "interesting" and "charming" the feelings were.
Very often those who were initially afraid would go all the more deeply into trance once
they got around their fear with this approach.)

Patient's Reality and Rapport


And she's removing herself from this reality
to go into a different reality
where R's reality and H's reality is changed
and mine is becoming less and less important.
And my voice?
I don't know exactly how
she hears it.
Maybe as a distant sound
which she does not feel a need to hear.
I am close enough to her
for her to hear me.
From that loss or change in body motility,
you can follow it,
it can tell you something about the character and ideation that's going through her
mind.
[Mrs. Erickson was called. She comes in and is told to try to hush up S's children, who
are playing loudly outside the office.]
E: To separate her from our reality (the tripart reality shared by E, R, and H) helps
deepen the trance by focusing her in on her own reality.
R: I see! If the hypnotherapist is interrupted in the middle of a session and has to speak
to a mailman or plumber who knocked on the door, it can deepen the patient's trance
reality because they are excluded and left alone with their own internal reality.
E: I discovered the hard way. Part of my early experience was in subjects always
awakening, and I had a lot of difficulty. I'd have one subject in one room and another in
another room, and they would awaken when I left the room. I discovered I had to leave
them in a certain way, so they would maintain their trance state. I had to assure them
they were not being deserted. They could rely upon me to return to them; I was only
temporarily absent. At first I told them that verbally, and later I learned how to use
nonverbal cues.
R: Like what?
E: "I'm here, you are here" (Erickson demonstrates how by repeating this formula in
different positions throughout the room the subject would get the idea that he was
always in rapport with them, no matter where he was actually located.) When I moved
away I'd say, "No matter where I am I will always be here." People don't know how
much they know about the locus of a voice (Erickson, 1973).
R: It's all unconscious learning.
E: Yes. (Erickson here refers to a manuscript he was writing [Erickson, 1973] about
how he actually produced seasickness in hypnotic subjects simply by changing the
locus of his voice by bobbing and weaving up and down and back and forth, mimicking
the changing locus a voice would have on a ship in rough waters.)

Learning to Speak in Trance


R: How are you feeling right now, S?
S: Hummm [very softly as if very far away] fine.
R: Can you describe anything of your state of awareness to us?
E: People have a lifetime of learning that talking in your sleep is socially unacceptable.
It's surprising how many people fear they will betray themselves by speaking in their
sleep or trance.
R: So you have to give patients special instruction and reassurance about their ability
to speak in trance. And you do that simply by asking how they are feeling.
E: I've already used words like "comfort" and "fine," so when she uses the word "fine," I
also know she is following my suggestions to feel comfort.

Voice Quality in Hypnosis


S: I can hear you. (Remote automaton like voice.) (pause)
R: To what do you attribute the automaton like or faraway quality of her voice?
E: It's due to a different muscle tone. Her face is ironed out, there is greater plasticity
and relaxation of all the muscles, including those controlling voice.

Extraneous Stimuli in Trance


[laughs]You're tickling me. [Personal voice as if she is nearly awake.]
[Actually the microphone cord inadvertently was bobbing against her knee as R was
adjusting it.]
R: That was quite by accident, it was the microphone cord. How did you experience
that tickling?
S: I thought maybe you were doing it to see if I would get out of this state. [Much
laughter.] I know Mrs. Erickson came in and she stepped on my toe, but it did not hurt.
[Even more laughter all around.]
R: What's your state of awareness right now?
S: Oh, I'm coming awake.
R: Fully awake?
E: She has this awakening reaction because I had not given her any specific
instructions to disregard all extraneous stimuli while in trance. You need to know that
any alien stimulus can enter into the trance situation, and you need to learn to deal with
it. Mrs. Erickson may be in a deep trance when the phone rings, and she may answer it
while remaining in trance. If it's an unfamiliar voice on the phone, she will wake right
up, but if she knows who it is, she may remain in trance altering her voice so the
person will not notice she is in trance. But if the other person is one of my hypnotic
subjects, they will recognize the trance.

Feeling of Distance in Trance


S: Oh, I'm back but slightly distant. (Pause)
E: That feeling of "distance" is a sign of trance. Nobody has really explained that sense
of being distant.
R: How would you explain it?
R: Every speaker in front of an audience has a sense that the audience is with me or
not with me; they are distant from me.
R: The feeling of distance then is due to feeling the lack of a shared-world-in-common
(Rossi, 1972a).
E: Yes.

Depotentiating Conscious Understanding


E: S has had the opportunity of discovering she can do that work. Now I have the right
to be as stupid as possible.
It isn't requisite for me
to understand all.
There can be progressive understanding on your part,
on H's part,
on the others' part.
(Pause)
And H need not be frightened
about hate
or frightened of the word: love.
You're terrified of new understandings of those words.
(Pause)
R: By saying that you "have the right to be as stupid as possible" you are making an
exaggerated and humorous suggestion about how little you need to understand
consciously. This implies that S and H need not use consciousness at this point either.
Later they can develop their conscious understanding, but for now let the unconscious
handle things. You then address a few therapeutically relevant words to H about being
"frightened" and so on.

Voice Tone as a Cue


And R and S have come to join us this time.
They called to find out if they could come,
and I knew it would be to their advantage and to your advantage (H) to have them here.
R: You apparently felt from nonverbal clues that H needed some reassurance at this
point so you simply talk about the pragmatic aspect of this joint session. You then
emphasize that it would be to everyone's mutual advantage to be together.
E: Yes. Notice I use a different tone of voice for "your" when referring to H and a
different direction of voice.
R: These voice cues are automatically and correctly interpreted by S and H, so they
always know when you are referring to each even though you use the impersonal
pronoun.

Other Names in Trance


Because
I could effect an interplay
that would be extremely valuable for you, for Herbie [the name previously assigned to
H's personality while in hypnosis], for R, for S.
R: When you do extensive work with some patients, as you have with H, you
sometimes give them another name in trance. Why?
(Erickson gives many examples from everyday life where one person—lover, mate,
parent, or child—may give another person a pet name to evoke a particular mood or
aspect of their relationship. A child will say "Father" or "Dad" or "Daddy" on different
occasions to constellate different aspects of the relationship with father. In trance the
patient may experience a particular ego state that the therapist wants to label with a
special name so he can help the patient return to it later.)

Rapport in Mutual Hypnosis


[H had been watching S very carefully, presumably to study her state of awareness. At
the moment Herbie is mentioned, however, his watching becomes more of a fixed
stare. S seems to notice this, and they silently and deeply look into each other's eyes
in a fixed, unblinking manner.]
R can watch S and you (H) can discover certain things. (Pause)
[S and H alternately blink. S's eyelids finally flutter and close, and then H's eyes close
also.]
And S has made a new discovery,
but then you [H] too have made a new discovery.
(Pause)
R: You arrange a hypnotic atmosphere where both are sitting quietly in rapt attention
and thus gradually developing a light trance. Now as they look at each other they
automatically mimic each other's hypnotic behavior (e.g., the staring and eye blinking)
and thereby go deeper into trance.
E: Yes. At this point H's distance was much greater than S's. R: You mean he was
further into trance?
E: He was further away. H tended to go into a reality that included himself and me but
excluding S and you.
R: So here you were trying to bring S and me into his inner reality more. But how could
you tell he was tending to exclude S and me? Was he turning away from us and
orienting bodily toward you?
E: A person could be looking right at you, yet you know they are not paying attention to
you without their even knowing they are not paying attention.
R: Yes, they will have that faraway look in their eyes.
E: But can you define that "faraway look" in precise terms?
R: That would be difficult. Then you are saying that this comes with experience. By now
it is almost an unconscious intuitive knowledge on your part.
E: Yes.

The Personal Meaning of Trance and Words


Now both of you want
profound trances
with hallucinations of the real
and of the unreal
and the organization of amorphous things.
Amorphous things, amorphous emotions, relationships,
and identities.
(Pause)
E: By saying "both of you want profound trances," I'm here beginning to effect a
separation between them.
R: You're saying that to each of them as separate people?
E: Yes. Each of them can have their own trance with its own individual meaning for
each. For H as a patient it is important to experience his diffuse emotions as part of his
therapy. For S as a therapist in training it is important to learn to recognize amorphous
emotions and relationships she will later be called upon to cope with professionally.
R: The same words will have different meanings for different people. This corresponds
to your frequent use of certain words that will have different meanings at different levels
within the same personality.

Time Distortion: Suggesting All Possible Responses


And when you spend time,
time can be of varying intensity.
It can be condensed,
it can be expanded,
so you can review a lifetime history in a few seconds time.
(Pause)
Those few seconds can be expanded
into
years.
Also a few days can be condensed
into a moment.
For both of you
it's a matter of your education
(Pause)
in dealing with patients
that you can take a patient's pain
and teach a patient to experience all of the pain
as a momentary passing twinge.
It can be very sharp only momentarily
even though it lasts all day.
Both of you want to learn how to expand time,
expand awareness,
and both of you need to know
that there is such a thing as
a contraction of time, feeling, pain, emotion.
A pleasing lecture of an hour's duration may seem like
it has barely begun when the hour is over.
Or in a boring lecture the chair begins to hurt,
and you get tired, and you wonder
when the hour will be up.
Both of you have had that experience in the past.
You know when you've had those experiences.
Now you're going to apply them to yourselves
in a way that helps your understanding of yourself
and your understanding of others.
(Pause)
E: Time distortion will be useful to both of them here in their different contexts.
R: You suggest all possible types of time distortion (condensation and expansion) that
may operate to whatever degree the patient finds himself using. You are thus following
your basic technique of suggesting all possible responses, so that it is almost
impossible for the suggestion to fail. Whatever the patient experiences has been
covered by your inclusive suggestion and can thus be counted as a success.
E: Again here the matter of education will be taken in a different way by each of them.
And so on for much of this material.
R: You use common everyday truisms (that both of these well-educated subjects are
certain to have experienced) to induce a "yes set" to enhance the plausibility and
acceptability of your suggestions.

Trance as a State of Active Unconscious Learning


And you both realize
thoroughly
that the hypnotic state
is not really induced by me
but by yourselves.
(Pause)
And H saw S do something with her eyelids,
and then he repeated it.
And S, in watching H,
in turn repeated what H did,
and she went into a trance.
Then H went into a trance also.
As far as R is concerned
he has learned that
the proximity of one hypnotic subject to another
does the same thing as is expressed
in folk language:
Monkey see, monkey do
which is a way of understanding
children;
they see, they do.
(Pause)
There is no importance in my talking to you;
time will just pass
and I can do as I wish.
(Pause)
R: Here you are putting the responsibility for trance learning on the subjects so they will
not be passively dependent on the hypnotherapist.
E: Yes. When they know they are doing it, they know they can alter their own behavior.
R: So that's an important way of reducing the magic and motivating them further in the
direction of therapeutic self change. The therapist provides the patient with a setting
and opportunity to do creative work. Trance is actually an active process wherein the
unconscious is active but not directed by the conscious mind. Is that right?
E: That's right.
R: This is one of your important contributions to modern hypnosis: getting away from
the automaton concept of the hypnotic state to conceptualize hypnosis as a state of
very active inner learning that takes place autonomously. Is that right?
E: Yes.
R: In a trance state you have released the unconscious to do its own work without
interference from consciousness.
E: And to do it in accord with the experimental learning of the subject.
R: Previously hypnosis was thought of as a state where the subject passively received
therapeutic suggestions.
E: By being told what to do and when to do it.
R: But your approach is frequently the opposite of that. You just let the subject get into
a trance state where he can do his own inner work.

Active Learning in Trance


Now each of you is learning something
pertaining to yourselves.
You are developing your own psychological techniques of psychotherapy
without knowing that you are developing them.
H now realizes
his tremendous response to the visual stimuli S gave him.
And S realizes that also.
(Pause)
R: Here, for example, you are instructing them to do their own inner learning, their own
inner work for themselves. They are not just to sit there passively. Could this be some
of the difficulty S is experiencing? She doesn't have the idea yet of doing her own inner
work, she is being too passive.
E: She tells us she's been skipping around, just looking.
R: That's characteristic of many subjects I'm learning to work with. They are just
hopping around. But that is not the state you are looking for.
E: It took one of my subjects 200 hours to learn. He would just sit there. S has been a
student, a scholar. She learns intellectually, but she doesn't know how to learn
something experientially. I've got to explain to her that she is to learn by experience.
Observing Pulsations
E: [to R] Notice that pulsation [in S's face].
Now I'm going to talk to R so you need not pay any attention.
R: Do you want to comment on the pulsations?
E: In watching the face in the trance state there are various places you can note the
pulsation. It isn't necessary for you to use your fingers on the wrist. Use your eyes on
the patient's ankle, neck, temple. Watch the changing pulsations. Often fluctuations can
tell you things. You learn to correlate pulsations with muscle tonus. You can suddenly
realize that increased pulsations means there exists a greater tonicity in muscles. You
can't really see the muscle tonicity develop until it develops to a certain degree but from
more rapid pulses you know the muscle is tighter. Now a slower pulse brings about a
lessening of tonicity. Body behavior in all parts of the body should be under your
observation.

Trance Distress:
Indirect Questioning
E: You also look for signs of perspiration, pallor, changes in facial expression, any
signs of distress. You're careful at such times.
R: When you note those distress signals you become very careful about what you are
saying. It could be traumatic.
E: That's right.
R: So even while a person is in trance you are careful about what might filter into their
conscious mind.
E: You don't push at such times.
R: How about when trance has terminated? Do you question them about their trance
distress then?
E: Only in the most general terms. (Erickson now gives a demonstration of how he will
gently imitate the head movements a patient made in trance while saying, "How about
here, there, up, down, from this to that," etc.)
R: If it's safe for the conscious mind to deal with the material, consciousness will pick
up your most general hints. If it is not safe, it will not understand what you're getting at.

Deepening Trance Through Spontaneous Learning


[E completely ignores H and S for about 10 minutes. He talks to R about certain
manuscripts on his desk which they are working on together.]
I think I will let H awaken first.
Now H, take your time,
count backwards from 20 to 1,
awakening l/20th at each count.
Begin to count now.
(Pause)
[H awakens and reorients his body.]
Now S, I want you to begin counting silently,
mentally from 20 to 1 and begin to count now.
(Pause)
[She awakens and reorients her body.]
R: It's rather remarkable they both took the same amount of time to awaken.
E: You see, when you're working with subjects, you let them have an opportunity to
experience their trance state without necessarily giving them anything to do. You leave
them to their own devices. It deepens the trance. They become more aware of what
they can do. They become more facile in their capacities.
R: It becomes a period of free learning for the subjects when you leave them to their
own devices.
E: Yes.
R: But S has been getting irritated with you because she may not know how to deepen
the trance by herself.
E: It's not something you learn to do consciously, it happens spontaneously; you only
know later that it happened.
(Erickson here gives other examples of spontaneous unconscious behavior such as
putting more salt on your food on a hot day without realizing it. When people, even
young children, move to a warmer climate, they learn this spontaneously on an
unconscious level.)
R: This again emphasizes that therapeutic trance is a state of active learning that takes
place autonomously without conscious intervention.

THE SURPRISE
Erickson frequently utilizes "surprise" to shake people out of their habitual patterns of
association in an effort to facilitate their natural patterns of unconscious creativity. The
problem with offering direct suggestions is that unless they are carefully integrated with the
patient's inner experience, they may interfere with the autonomous and creative aspect of
trance experience. If trance is a focus of a few inner realities that move by themselves, then
the therapist's direct suggestion may come as an intrusion on that autonomous inner flow.
The direct suggestion might inadvertently activate the patient's conscious intention to try to
do something on a voluntary level. By asking patients simply to "wait for a surprise," on the
other hand, we are allowing them to remain in quiescence while unconscious processes
gradually mobilize a truly autonomous response.
"Surprise" is an agreeable word to most people. It conjures up many associations of
pleasant childhood experiences and surprise parties and gifts. The ego is usually receptive to
a surprise. A surprise always implies that the subject will have no control—and that, of
course, facilitates autonomous functioning. The word "surprise" is thus a conditioned cue for
most people to give up control and to be curious about the pleasant thing that is going to
happen to them.
E: Or would you like to have it as a surprise?
Now or later?
R: That question actually implies a pleasant experience will happen. To that surprise is
added another about time.
Shortly I'm going to lift your hand in the air. What happens after that is going to
surprise you.
E: When the subject goes through all the possible surprises, what can surprise them?
R: An unusual thing.
E: And what unusual thing is there? The hand could stay there and the subject cannot
put it down.
You are pretty well aware of all the things you can do, but the most surprising
experience you can have is to discover that you can't stand up, n ... o ... w.
R: The first part of this statement is a truism: the subject knows what she can do. The
surprise about not being able to stand up comes as a shock that tends to depotentiate
her usual conscious sets and facilitate the immobility of the lower body. This surprise is
thus another classical example of not doing. The drawn-out emphasis on the word "n. .
.o. . .w" evokes a curiosity response from the subject, who says to herself: "What does
that mean? Is anything happening? What has happened?" These questions allow an
opening and time for the autonomous process of immobility to develop. The typical
subject then begins to move the top part of her body to test the suggestion but leaves
the bottom part from the waist down immobile. Frequently the therapist can give the
subject a surprise slap on the thigh so she can experience the further surprise of a
caudal analgesia.
Another example of the surprise was related by Erickson as he discussed his permissive
approach in allowing patients to express their own variations to a hand levitation approach.
"The therapist's attitude should be completely permissive so a patient can respond in any
way to hand levitation—even by pushing down harder and harder. I'm thinking of a certain
college student who did that. After he did that long enough I said, 'It's rather interesting—at
least it is to me. 1 think it will be up to you when you discover that you can't stop pushing
down.' He thought he was resisting. The idea that he couldn't stop took him completely by
surprise and it was a full-grown idea when it hit him. That would be something he would be
interested in. He would be surprised! He couldn't be surprised unless he couldn't stop
pushing down. Not being able to stop pushing down was made contingent upon the idea of
interest and a surprise. He found to his surprise that he couldn't stop pushing down and he
asked, 'What happened?' I said, 'At least your arms have gone into a trance. Can you stand
up?' Can he? That simple question elaborated 'At least your arms have gone into a trance,'
and extended it to his feet. Of course, he couldn't stand up. There was only one conclusion to
reach: his body was in a trance because he no longer had control over it. That apparently
was what he wanted—to regard hypnosis as a condition in which you have no control over
yourself."
The shock and surprise this student experienced must have been all the more upsetting
since he obviously had a high investment in not following suggestions, as is indicated by his
pushing his hand down when it was suggested that it levitate. In this case Erickson states,
"Not being able to stop pushing down was made contingent upon the idea of interest and
surprise." Erickson did, in fact, succeed in evoking interest, shock, and surprise with his
provocative statement, "It's rather interesting—at least it is to me. I think it will be to you when
you discover that you can't stop pushing down." He evoked a shock and surprise that
momentarily suspended the student's belief system. In that precise moment he added the
suggestion, "You discover that you can't stop pushing down."

Exercises with Surprise


1. Surprise has a number of possible functions in hypnotic work.
a. A shock and surprise can momentarily depotentiate an individual's habitual
mental sets so that perception and understanding may be spontaneously reorganized in a
new way.
b. An anticipation of a pleasant surprise has motivating properties and leaves the
individual open, aware, expectant of something. That something can be either a new insight
from within or an important suggestion from the therapist.
c. The anticipation of a pleasant surprise allows the ego to relax so that more
autonomous processes can function in a way compatible with trance.
Plan how you could utilize the above characteristics of surprise to enhance an experience of each
of the classical hypnotic phenomena.
2. To learn something about a person's fundamental world view and habitual frames of
reference, ask about their most "surprising life experience." And what would be the most
surprising thing that could happen to them?
3. Once you understand something about a person's world view, plan how you could say
or do a simple and innocent thing that is a bit outside that world view so the person is
shocked and surprised. Of course, tact and good taste are required for such adventures.
With experience you can learn to elicit a double-take and a laugh from people as they
spontaneously reorganize their perceptions and/or accept a suggestion you offer them at that
critical moment of surprise when there is a momentary suspension of their habitual sets and
patterns of understanding. This kind of approach is used by professional comedians and
some skillful orators.

THE CONFUSION-RESTRUCTURING APPROACH


A major theme reiterated again and again in the most surprising contexts by Erickson is
that the patient "does not know" what is happening. Of course, consciousness is at all times
limited. Consciousness focuses on this or that, ever shifting from moment to moment. At any
given moment it can only be focused on a limited range of information. Erickson utilizes this
limitation by continually introducing changes in areas outside that momentary focus of
consciousness. If he can be sure that the patient's consciousness is focused in area A, then
he will introduce a change in area B. When the patient's consciousness returns to refocus on
B, the patient is in for a surprise: an unexpected change has been introduced. This surprise
throws off patients' usual reality sense, they become confused, and they reach for and
accept any suggestions that the therapist can introduce to restructure the lost reality.
In chapter One we discussed how Erickson did not find hypersuggestibility characteristic
of trance (Erickson, 1932). We can now more clearly understand what he meant. Under the
shock and surprise of many of the older authoritarian approaches to hypnotic induction, it is
obvious how the confusion-need-for-restructuring mechanism operated so automatically that
it appeared as if the patient was hypersuggestible in trance. This so-called
hypersuggestibility, however, is actually the automatic acceptance of any acceptable
restructuring that will end the intolerable confusion that has been effected by the hypnotic
induction or any means of unstructuring the ego's usual frames of reference.
The basic process required for the acceptance of suggestions by the confusion-
restructuring approach, then, is as follows.
CONFUSION
due to shock, stress, uncertainty, etc.

UNSTRUCTURING
of usual frames of reference

RESTRUCTURING
needed

RECEPTIVITY
to therapeutic suggestions
The reader can understand the above as intervening steps between stages two and
three of the flow diagram presented in the previous chapter on Confusion in the Dynamics of
Trance Induction. Acceptance of the therapist's suggestions will be in direct proportion to (1)
the optimal degree of unstructuring and (2) the appropriateness of the therapist's suggestions
for restructuring a particular patient in a therapeutic manner. What people can accept as
restructuring is very much a function of their therapeutic needs and goals.
Erickson uses this basic method of confusion-restructuring in therapy as well as in
inducing hypnosis and facilitating the acceptance of suggestions. He has described many
instances where he uses shock (Rossi, 1973b)—for example, to unsettle a patient's problem
so the patient will grasp therapeutic suggestions to restructure a now shaken sense of reality.
A rather dramatic example of Erickson's use of confusion-restructuring in induction is in the
situation where a nurse reluctantly came to the front of an audience to serve as a demonstration
subject. As she approached Erickson he confused her as to which chair she should sit in by
unexpectedly directing her alternately from one chair to another. (He directed her nonverbally to
one chair while verbally indicating another.) When she was thoroughly perplexed, he finally said,
"Go into a trance as you sit all the way down," and simultaneously indicated clearly which chair
she should sit in.
Such approaches are obviously only suitable for therapists with quick wits and some
practical experience. There are, however, many types of confusion-need-for-restructuring
situations in everyday life and psychotherapy that can be creatively utilized by any therapist.
The momentary confusion of a loud noise or unexpected event, for example, produces a
momentary gap in understanding that requires an explanatory suggestion. Erickson is
continually playful in the way he introduces puzzles and oddities in the therapy situation that
confound the mind so it will be receptive to suggestion. He will ask someone a beguilingly
simple mathematical question, or drag out some fascinating esoterica from a Believe-It-or-
Not article. By such simple means he confounds the usual limiting sets of consciousness and
awakens a need for explanation and restructuring. A "yes" or accepting set is established,
and the patient is grateful for anything new the therapist can then introduce.
Readers will have to determine for themselves the degree to which these various levels
of confusion-restructuring can be used comfortably in their own therapeutic practice. A simple
awareness of the confusion-restructuring process can be of immense value regardless of
how the therapist feels about purposely provoking confusion. Most patients bring in enough
confusion of their own which they want therapy to resolve! Rather than viewing such
confusions negatively as indicators of pathology or problems, however, the therapist can look
upon them as opportunities to help patients restructure their world.

Exercises in Confusion and Restructuring


1. Surprise, confusion, and restructuring are all intimately related processes. To learn to
utilize them creatively in therapy requires a certain flexibility in the therapist's world view.
Creatively oriented therapists will therefore seek out life experiences that will enable them to
continually break out of the limitations of his own habitual framework (Rossi, 1972b).
2. Uncertainty, ambivalence, and confusion are typical complaints of people who come
to therapy. These are frequently treated as symptoms the therapist is supposed to remove.
We can now understand how they are actually a preliminary stage for the possible creative
change and growth of the personality (Rossi, 1972a; Rossi, 1973). Learn to recognize in
these complaints the outlines of what is changing in a patient's world view and how that
change can be facilitated in a growth-enhancing manner.

THERAPEUTIC TRANCE AS A STATE OF ACTIVE


UNCONSCIOUS LEARNING
Erickson makes it clear that therapeutic trance is a state of active learning on an
unconscious level; that is, learning without the intervention of conscious purpose and design.
Trance experience may be likened to that of the dream wherein mental events usually
proceed autonomously.
There may be a question here as to whether this is true learning (in the sense of an
acquisition of new responses) or merely automatic behavior on an unconscious level. The
proof of new learning must always lie in the results: Does the patient actually evidence new
response capacities as a result of his hypnotic experience?
Erickson continually emphasizes learning without awareness. In this induction section,
for example, he says to Drs. H and S, "You are developing your own psychological
techniques of psychotherapy without knowing that you are developing them." He clearly
believes that such learning can take place more effectively and creatively in an altered state,
when many of the usual biases and preconceptions of the patient's conscious frame of
reference are not active. Therapeutic trance is thus a condition wherein the usual biases and
distractions of consciousness are minimized, so that new learning can take place most
efficiently.
This view is entirely consistent with what is known about the creative process in general
(Rossi, 1968, 1972a; Ghiselin, 1952), wherein it is recognized that consciousness is only a
receiving station for the new combinations of the creative process that actually take place on
an unconscious level. It is also consistent with the early hypnotherapeutic approaches of
Liebeault, Bernheim, and Braid (Tinterow, 1970), who would sometimes place patients in a
healing trance for a short time and then "wake" them up without any further direct
suggestions about exactly how the therapy was to take place. The "healing atmosphere"
provided by such early workers together with the belief system of their times functioned as
indirect and nonverbal suggestions to set in motion creative, autonomous processes within
their patients that could effect a "cure." Modern 20th-century man is handicapped, however,
by a materialistic, and overrationalistic belief system that tends to downgrade the functioning
of these autonomous therapeutic processes. Modern man has an unfortunate hubris of
consciousness (Jung, 1960) wherein he believes everything mental can be accomplished on
a conscious and voluntary level. Such voluntary efforts frequently get in the way of natural
healing processes. To cope with these misguided conscious efforts, Erickson developed
indirect approaches such as confusion and restructuring as a means of confounding patients'
conscious limitations so their unconscious has an opportunity to create new solutions.
FIVE

Trance Learning By Association


In this session Erickson again uses a more accomplished subject, Mrs. L., to
demonstrate hypnotic responsiveness so that Dr. S can learn by association. Erickson begins
with a surprise: he asks Dr. S to perform her first hypnotic induction on another person. She
does this surprisingly well in a way that is original while still utilizing a number of basic
principles of hypnotic induction. The significance of this surprise request is that it prevented
Dr. S from rehearsing ahead of time; it forced Dr. S to rely on her intuition and the
unconscious learning she has acquired thus far in her personal experiencing of trance.
Erickson encouraged her to learn to use experiential rather than intellectual knowledge.
In this session Erickson returns to the theme of unconscious learning as a basic issue in
doing genuine trance work. He comments that Dr. S still "doesn't quite trust her unconscious
mind to do all the learning necessary." He clearly means that during trance the patient is
learning without the usual mode of ego consciousness. Consciousness is not necessary for
learning. Indeed, Erickson prefers learning to take place without the biasing intervention of
consciousness.
In experimental psychology it has been demonstrated that learning can indeed take
place without awareness (e.g., the so-called latent learning). Such learning without
awareness is Erickson's preferred way of working with patients in trance. Erickson has
commented on the fact that much of what passes for hypnosis in the experimental literature,
where a short induction of a few minutes' duration is followed by standardized suggestions
(that do not take into account or meaningfully utilize patients' individual differences), is
actually a mixture wherein the patient uses conscious volition mixed with unconscious
learning. This reliance on conscious volition and direction is the mark of an inadequately
trained hypnotic subject. Such subjects will quickly reach a limit in the degree to which they
can experience genuine hypnotic phenomena because their conscious sets and learned
limitations interfere with the efficient functioning of unconscious mechanisms.
Two indirect approaches to utilizing such unconscious mechanisms are clarified in this
session: the implied directive and questions, These approaches have been developed by
Erickson and others in clinical hypnosis. It will be fascinating and important to study the
parameters of these approaches with more controlled laboratory studies as well as further
field and clinical investigations. We are just now beginning to appreciate the complexity and
vastly unrealized potential for using language to effect therapeutic goals.
In this session Erickson requested Mrs. L, an excellent hypnotherapeutic subject with
whom he has worked before, to be present. In a surprise move he asks S to hypnotize L.
This is the first occasion on which Erickson is able to observe work with hypnosis as an
operator. S begins by addressing her suggestions to the subject.

A Successful Practice Induction


S: Close your eyes, relax, and imagine yourself in a fantasy spot which you liked very
much.
(Pause)
Either by a lake or river, just some place you like.
(Pause)
You manage to get more and more relaxed. Take a deep breath and relax.
[Subject does take a deep breath at this point.]
You start feeling more and more comfortable.
(Pause)
E: "Imagine yourself in a fantasy spot," makes it very personal. "Either by a lake or a
river," now introduces reality. It becomes the patient's reality when she adds "just some
place you like." "Take a deep breath," is a very safe suggestion because any patient
has to breathe.
R: Yes, so S is safe in going along with what Mrs. L is naturally doing.
E: And you can add any adjective you want, in this case a "deep breath." The adjective
"deep" is a suggestion that is facilitated by being associated with an inevitable
response: the patient will have to breathe.
R: So this was an excellent progression of suggestions that S used here:
E: Yes. But those suggestions take Mrs. L far away from this room. They take her to
some specific memory, but S doesn't know which.
R: That's the problem. A really experienced operator would know exactly where the
patient was being placed unless a general exploration was wanted.

Hypnotic Tautology
You'll find this world your very own world that you'll like very much.
(Pause)
Okay. Let's try a few signals, Okay?
(Pause)
Let this be the "yes" finger right here.
E: Given what goes just before, why shouldn't she like this world very much? You're not
telling her to like it, you're just stating an obvious fact. The subject is not obeying like an
automation. She will here simply agree that she does indeed like this place and feel S
respects her.
R: So again S is doing very well here. She initiates an experience of relaxation and
comfort in a place Mrs. L likes. She then announces that Mrs. L "will find this world . . .
you'll like very much." This is actually a hypnotic tautology: S sets up a pleasant
experience and then says it is a pleasant experience. Mrs. L, immersed as she is in the
experience, however, does not recognize the tautology; she simply feels comfortable
and respected as well since S is seemingly so correct in describing her inner
experience.

Implication and Indirect Suggestion


[S taps Mrs. L's right forefinger.] And when you are feeling very peaceful and
comfortable, you can concentrate on "yes"
and you may notice that finger float up.
O.K., you can do that now. You can concentrate on "yes."
[Pause as one of Mrs. L's fingers levitates.]
That's right.
E: "You can concentrate," is a statement of fact, it is not a command. If I say, "You
can," it implies, "you can do that or something else." It is not a direct order. It is an
inoffensive way of directing.
R: So whether S realizes it or not, she has been learning something in her personal
hypnotic work with you: she's learned how to use implication and indirect suggestions.
Indirect Instruction
You are going to find that each time that you may want to spend a few minutes by
yourself, relaxing, feeling very comfortable and serene,
that you can go back to this feeling,
you can put yourself into this world anytime that you like.
There are times when you really need this serene feeling.
(Pause)
O.K., now, anytime that you would like to come back and join us, you can just take a
deep breath, stretch.
[Mrs. L awakens, stretches, reorients to her body. A general conversation takes place
for about five minutes. Erickson then undertakes to hypnotize Mrs. L.
E: Yes. "Times when you really need." What times? You're naturally going to have
some memories of some times. So this is her own exploration. She will explore, but S
has not told her to explore.
R: So again in a very indirect and innocuous way S has sent Mrs. L on an exploratory
trip.
E: Self-exploratory and yet not for the purpose of seeking names, etc., but for seeking
serenity.
R: It seems that S has been learning something about the indirect approach to
suggestion in her work with you.

Erickson Induction by Recapitulation


E: I would like to have you do today what you did yesterday.
[Pause. Mrs. L's six-week-old baby begins crying very loudly in the background, but
Mrs. L pays no heed.]
You can make your own count from 1 to 20. Now you know that today's a change and
go very deeply into a trance,
R: In this simple introductory statement you are recapitulating previous successful
hypnotic work, and you're thereby reactivating associations that will facilitate your
present hypnotic work.
R. Why did you talk of "change" here?
E: The baby crying out there was not present when I worked with Mrs. L previously.
Therefore she had better change herself so that she could accommodate this new
stimuli without being disturbed.
R: Without telling her directly that she supposed to ignore her baby today.
E: I gave her enough credit to know what I meant by "change."
R: If you had said directly, "Ignore your baby's crying," she would certainly have
resisted.
E: What woman wouldn't?

"Losing Abilities" Rather than Direct Commands


and you learned the other day
how you could lose the ability
to stand up.
Now you can lose the ability to keep your right hand on your thigh
R: You don't command her, "You will not be able to stand up! 'You just emphasize a
natural behavior since we all can lose the ability to stand at one time or other. It's
relatively easy to lose an ability. In trance it is much easier not to do something rather
than making all the effort to do something.
E: That's one thing people don't know about themselves. They don't know they can
lose the ability to stand up. They don't know they can lose the ability to speak. Yet is
happens all the time, as when they remark," I stood there like an idiot unable to say
anything in that situation. I didn't know, enough to say anything!"

Suggestions as Inevitable Behavior


because no matter what you do
it will move up toward your face.
[Mrs. L's hand does begin to levitate smoothly toward her face.]
You can have the experience of being all alone
with only a voice.
My voice.
And soon you won't even know whether your eyes are open or closed.
You don't need to know.
And now your hand is stuck to your face.
(Pause)
You can go back to Columbia.
(Pause)
E: The patient's common reaction here is, "It will not move up to my face!" But they will
be doing something, and "no matter what" they do they wind up touching their face.
There is an ever-continuing threat. For example, "Try harder!" No matter how hard they
try to keep their eyes open, you know they will close sooner or later.
R: This is the logic of many induction suggestions: What the operator says is always a
foregone conclusion. Subjects do not realize that the resistance they are attempting is
impossible, and they then attribute their failure to resist as giving in to the operator's
power of suggestions.
E: Another example would be, "You don't know when you're going to change your rate
of breathing."
R: Sooner or later everyone will change their breathing rate. You thereby also develop
a set for "change" which is so important for therapy, and at the same time you
depotentiate consciousness by saying, "You don't know."

Unconscious Knowledge
I would like you to learn
that no matter what any person believes,
your belief,
your unconscious belief,
your unconscious knowledge,
is all that counts.
(Pause)
In the course of living from infancy on,
you acquired knowledge,
but you could not keep all that knowledge in the foreground of your mind.
(Pause)
In the development of the human being
learning in the unconscious
became available in any time of need.
When you need to feel comfort, you can feel comfort.
When you have a need for relaxation,
you can have it.
R: Here again you are emphasizing the importance of the unconscious at the expense
of the conscious.
E: Yes.
R: In referring to the acquisition of knowledge from infancy and the potential availability
of such knowledge, you are making an effort to activate association pathways to
unconscious learning and knowledge that can be utilized in dealing with current
problems. You closely associate this suggestion with the ordinary ones for comfort and
relaxation that have been successful with S. This association of a new suggestion with
one that has been previously successful tends to facilitate the new suggestion.

Hypersuggestibility as an Artifact
And many times in the past
you have been able to hear something
and to forget it immediately.
(Pause)
It is a common experience.
When being introduced,
you shake hands and go on to the next person.
And wonder what Mrs. Jones' name is
(Pause)
while you are shaking hands with Mrs. Smith.
Your mind has that
knowledge,
and you don't even need
to know that you have it.
(Pause)
Months later you can meet Mrs. Jones on the street and spontaneously call her by her
name.
You don't even need to know when or where you met,
for when the occasion arises,
your unconscious will supply that knowledge.
R: Here you begin to elicit forgetting mechanisms by leading her into association
pathways where forgetting is likely to occur. This is very typical of you; you rarely give
direct suggestions. In one of your early papers [1932, Possible Detrimental Effects of
Experimental Hypnosis] you even say of your experience with thousands of trances
that "hypersuggestibility was not noticed." Is it possible you don't believe that
hypersuggestibility is characteristic of trance? You substitute the gradual elicitation of
natural mental and behavioral mechanisms by verbal and nonverbal associations for
the so-called phenomenon of hypersuggestibility of trance. Hypersuggestibility is
actually an artifact?
E: Yes. It's just called hypersuggestibility.
R: But it's really natural mental and behavioral mechanisms the operator has
succeeded in leading a patient into. The art of hypnosis is the skill with which the
therapist succeeds in evoking these natural mechanisms for a specific therapeutic
purpose.

The Implied Directive


As soon as you know only you and I,
or you and my voice are here,
your right hand will descend to your thigh
[Pause as her hand begins to descend]
here is only here,
nothing more.
(Pause)
You don't even need to know your name.
As you learned a long time ago
you are me,
and me was everything.
(Pause)
I would like to have you count backward from 20 to 1,
and begin the count right now.
R: This is a subtle form of directive where you don't actually tell her to do something,
but you assume something will be done. You then only give her the option of signaling
when it is done. The giving of the signal when it is done actually seems to have both
motivating and reinforcing properties on the implied directive.
E: A parallel with ordinary behavior is when you eat or drink until you are satisfied. You
will know when the eating and drinking are done.
R: Do you agree that "the implied directive" is a good name for this?
E: Yes. I'm not telling her to ignore the presence of others in the room. No one can do
that. But you can limit your awareness. We all have had extensive training in limiting
our awareness.
R: We can limit our awareness to a book, a movie, etc. Actually that is another way of
describing concentration: the mind focuses on one limited area and omits everything
else.

Trance as Altered State


[Mrs. L opens her eyes but does not reorient to her body. Therefore she is still in
trance.]
Tell us what you think we've experienced.
[ Pause. Mrs. L's baby continues crying very loudly.]
L: We were talking and we were very comfortable.
E: Do you hear your daughter?
L: Yes.
E: How do you feel about that?
L: Comfortable.
E: Does it distress you?
L: Somewhat, but I don't want to help her right now.
E: That's an odd feeling, isn't it?
L: Yes.
E: It's a nice thing to learn
because it will teach you objectivity,
which will enable you to do right things at the right time
in the right way.
A little exercise by your daughter
is good for her.
R: Because she did not reorient to her body we know she was still in trance even
though she opened her eyes.
E: The fact that she still is "comfortable" and does not want to bother helping her crying
daughter also verifies the trance state. There is something lacking there in the total
awareness of the self and the situation.
R: Showing that she is in an altered state.
E: An altered state, and she knows it! A person in trance doesn't feel certain things that
are appropriate.
R: So this helps us to understand trance as an altered state.
E: Yes. Her verbal statement means: I know the baby should be attended to, but I don't
feel like it; the momentum does not exist to lead me to the effort to attend to her.
R: In trance the motivating properties of stimuli are lost?
E: There is a limitation of what would normally be spontaneous behavior.
R: There is a limitation of the ego's executive function of relating appropriately to the
outside world. They do not relate to the outside world except through the therapist.

Double Bind Question for Ratifying Trance


E: You really think you are awake, don't you?
L: No.
E: That's right, you don't.
(Pause)
R: You are affirming the trance with this double bind question? E: Yes. I'm proving the
trance exists.

Negative Visual Hallucination


E: Who is here?
L: You are.
E: Who else?
L: I don't know.
E: Is your daughter's voice here?
L: Yes.
E: That's a nice sound, isn't it?
L: Yes.
E: How do you feel about being in a trance with your eyes wide open?
L: I like this better.
Because then I know what is going on.
E: And what is going on?
Are you enjoying yourself?
L: Yes.
R: Her response of not knowing who else is here is actually a negative hallucination;
she is apparently unaware that S and I are seated right next to her, well within her
range of vision. So here she has lost the ability to be aware of our presence, which you
earlier suggested to her in the form of the implied directive.

Literalism to Evaluate Trance


E: What am I doing?
L: Talking.
E: Anything else?
L: Looking at me.
E: Anything else?
L: No.
E: And how are you seeing me?
L: With my eyes.
E: What else do you see?
L: That book.
R: The literalism of these responses ("talking," "looking at me," "with my eyes") is a
classical indication of deep trance. You might appear to be having a casual
conversation, but you are actually making a careful evaluation of her mental state.

Questions as Suggestions
E: Can you look and not see?
L: Yes.
E: And we can be all alone here.
(Pause)
Or someone named S can join us.
R: Posing a suggestion indirectly in the form of a question carries less risk of failure. If
they cannot accomplish the suggestion they simply say "no" and nothing is lost. We
don't know if she actually did experience a negative hallucination of not seeing here
since you did not test it.

Indirectly Motivating Trance:


Resistance and Unconscious Learning
Look at S.
Tell S to count to 20.
L: Count to 20, S.
E: And to take a deep breath at the count of 20.
L: Take a deep breath at the count of 20.
(Pause)
E: What change do you notice in her?
L: She breathes slower,
her head lowers,
her eyes are closed.
(Pause)
E: What else do you notice?
L: She is relaxed,
her hands are on her legs.
E: Do you think she knows her hands are there?
L: I don't know.
R: Why do you have Mrs. L in trance now hypnotize S?
E: I've had subjects determined not to go into a trance even though they volunteered. I
let them express their resistance, and then I tell them to hypnotize someone else.
When they hypnotize someone else they start wanting the hypnotic trance to develop.
R: So you've changed their set from resisting trance to wanting trance by making them
an operator.
E: They now want a trance, but it's not been defined necessarily as trance in another.
R: This is an interesting example of how you indirectly enhance motivation for trance
experience. At some unconscious or preverbal level an individual does not distinguish
between "wanting a trance" for oneself or another. Wanting a trance for someone else
will, by association, evoke partial aspects of trance in oneself and therefore enhance
the possibility that one will more easily experience a trance if given an opportunity at
that time. You were treating S as a resistant subject here?
E: Oh, yes. Her resistance isn't toward me or toward learning. She just doesn't quite
trust her unconscious mind to do all the learning necessary.
R: Her conscious mind keeps coming in during her trance efforts.
E: To make sure.
R: This is a typical problem many intellectually trained professional people will have in
experiencing trance and learning on an unconscious level.

Not Knowing:
Utilizing Established Learning
E: You don't need to know where your hands are.
S doesn't need to know where hers are.
(Pause)
R: Here again you use not knowing: "You don't need to know where your hands are."
You don't try to directly suggest, "Have no awareness of your hands." You simply point
out that she need not know where they are. This utilizes that everyday mental
mechanism where we don't actually have to know where our hands are such as when
we watch TV or a movie, for example.
E: When driving a car you don't always have to have your foot on the brake. You don't
need your best dress today. There are a lot of don'ts in life.
R: You keep emphasizing all those "don'ts" and things you don't need; it's a means of
relaxing the directing and controlling functions of the patient's ego.
E: By using established learning patterns.
R: So instead of giving direct suggestions, you use established learning patterns that
are already present in the subject.

Positive Visual Hallucination


E: And in some way
I want you to see someone
who is someone between you and me
whom you haven't seen in many years.
[R was actually seated between E and S. Mrs. L opens her eyes and studies R very
carefully, and then with a slightly incredulous look She begins to talk with R, who
gradually assumes the role of John which she gives him.]
L: John:!
E: Who is John?
L: He is a friend from college.
E: Now speak to him.
L: Hi.
R: Hi.
L: How have you been doing?
R: Pretty good.
L: Are you still in the Air Force?
R: I left.
L: Where are you living now?
R: Where would you expect?
L: Puerto Rico?
R: Yes. [A general set of questions and answers now takes place between Mrs. L and
R playing the role of John.]
R: You never did positive visual hallucinatory work with Mrs. L before. Did you know
she was going to respond so well to it?
E: She is a very good subject. She is a very gentle, soft personality, simple and
uncomplicated. Such a personality does not feel insecure when you offer them
something.
R: You don't command or apparently even suggest: you offer and thus utilize her own
inner needs and motivation. You've also built up your successful suggestion with her by
first evoking a series of easier phenomena. You had her remain undisturbed by her
crying child, lose the ability to stand, engage in hand levitation, forgetting and negative
visual hallucination before you felt sure enough to attempt a positive visual
hallucination. This positive hallucination may be actually more in the nature of an
illusion since she is actually seeing me and distorting my image to fit the image of her
friend John. Presumably the next step would be a genuine visual hallucination of
seeing something out there in space without any reality props.

Doubting Questions in Depotentiating Consciousness


E: Now listen to what I say carefully and really understand what I say.
E: "Do you really understand?" means "distrust your conscious understanding."
R: You're throwing doubt on the conscious mind again even though you seem to be
saying the opposite.
E: That's right! "Do you really understand!" implies a strong doubt. To say, "And you will
really understand" means the same as "you don't really understand." It has the same
meaning either way you state it, positively or negatively.

Questions Ratifying Hallucinations


Why did John just leave!
He did, you know.
L: He went back home!
E: Where was he sitting!
L: On a chair.
E: Can you look over in the direction of the place where he was sitting!
[Mrs. L now looks at the seat of the chair still occupied by R. Her looking at the seat is
in marked contrast to the way she looked at his face when she was talking to him
earlier when she projected John on him. Looking at the seat as she is suggests that
she is now not seeing R sitting there.]
E: What kind of chair was he sitting on?
L: A green chair.
E: Tell me when you think he left.
L: A few minutes ago.
E: Was he willing to go?
L: Yes.
E: Why was he willing to go?
L: He wasn't needed anymore.
E: Did you enjoy seeing him?
L: Yes.
E: I'm emphasizing John was here. He had to be here in order to leave.
R: So you're ratifying the fact that she has just had an hallucinatory experience.
E: Yes. He can't leave unless he has been here.
R: At the same time you're telling her to make him disappear.
E: Yes. But you're making her affirm he was here.
R: You ask, "Why did John just leave?" rather than simply tell her to erase the whole
experience and run the risk of her denying that it ever happened in the first place.
Actually, I've notices that all questions have a hypnotic effect insofar as they fixate and
focus attention. Is this why you ask so many questions?
E: The patient needs help, and he does not know where to look, so I'd better focus his
looking with a question.

Utilizing Patient Motivation for Visual Hallucinations


E: Is there anyone else you would like to see
that you haven't seen for a long time?
L: Yes.
E: Who?
L: Bill
L: Bonjour
[Mrs. L begins to speak French to an hallucinated friend, Bill, who is now projected on
Rossi. She now looks at Rossi's face as she speaks to him.]
R: [Playing the role of Bill] Let's speak English today.
L: No.
R: By asking this question about who she would like to see, you're utilizing her internal
memory banks and motivation to facilitate a hallucinatory experience.

Impossible Suggestions Arouse Discomfort and Resistance


R: How come? Is it not possible for me to have learned English?
L: No.
E: Your French is rusty, L. How come this person says some English words?
L: He understands, he knows one or two words of English.
[Mrs. L frowns doubtfully and appears uneasy.]
E: Everything is fine, L.
Very, very fine.
(Pause)
I want you to feel very pleased within yourself, would you?
R: Since it did not fit her internal understanding of Bill, my suggestion that Bill could
have learned English had no effect. Even though she is experiencing deep trance, an
obviously impossible suggestion does not work. It arouses discomfort and resistance.
Suggestions must match the patient's internal needs and patterns of learning and
motivation to be effective.
E: Yes, this difficulty is a good example of that.
R: You were quick to reassure her when she showed uneasiness about the
inconsistency of her friend Bill knowing English.

Indirect Age Regression


Now listen to my words
very carefully.
Listen to them very carefully and understand them.
Do you think A will propose? [A is Mrs. L's husband of many years.]
L: Yes.
E: What makes you think so?
L: He loves me.
(Pause)
[Conversation wherein an age-regressed Mrs. L describes some of her husband's
feelings for her as she experienced them before they were married.]
R: You solicit her careful attention to prepare her for the subtle indirect suggestion that
is to follow. By using the future tense here you imply that L's husband has not yet
proposed. This reorients her to the past before she was married. So you've effected an
age regression without any direct suggestion for it.
E: Yes. And here again when I say, "What makes you think so?"

Structured Amnesia
E: Close your eyes,
and shortly I am going to awaken you,
and when I awaken you,
it will seem to you as if you had just sat down and were waiting for me to begin.
Is that all right?
L: Yes.
R: By reorienting her to the time before we began trance work, you are effecting a
possible amnesia for the trance work that just took place (Erickson and Rossi, 1974).

Surprise for Ratifying Trance by Counting Reversal


Now I am going to start the count
now: 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 9, 10 11, 12, 13, 14, 15, 16, 15, 14, 13,
12, 11, 10, 9, 8, 7, 6, 5, 4, 3,
(Pause)
2,
(Pause)
1
How do you feel?
L: Fine.
R: Why do you do this counting reversal as you're waking her up?
E: You take them by surprise. They think you've made a mistake. And then they find as
you count up toward 20 they are following the instruction to go deeper and deeper into
trance. You reverse it downward again, and now they know from personal experience
that they were deeper. They were lighter in trance and then deeper.
R: You're proving the efficiency of counting to vary trance depth.
E: Yes. I've had patients tell me "that was an awful jerk when you reversed the count."
R: That jerk proves and ratifies the trance.
E: That's their subjective proof of trance—not mine.

Successful Posthypnotic Suggestion


E: Are you ready to begin work?
L: Okay.
E: What do you think we will do?
L: I'm not sure what we are going to do. I suppose you want me to work with Dr. R so I
will have a different experience.
I don't know why the tape recorder.
E: You don't?
L: No.
E: What is S doing?
L: She looks like she's asleep.
E: Have you or I bored her that much?
L: I doubt it.
E: Is she asleep?
L: Yes.
R: The fact that L is successful in following this posthypnotic suggestion which S in part
failed last session indicates that L is more accomplished in trance learning. Allowing S
to witness this while she is in the trance state makes it more likely that she will do it in
the future.

Direct Authoritative Help for Uncertainty


[S makes motions as if to awaken]
E: Is her sleep stopping?
E: [To S] Go far away?
S: Yes.
E: Very far away.
[S now goes deeper into a trance while Erickson engages Mrs. L and R in a casual
conversation wherein it is learned that Mrs. L does not recall that she has been in a
trance state. Erickson now proceeds with Mrs. L as follows.]
R: S was seemingly about to wake up here.
E: You use a direct authoritative suggestion in this situation where you see a patient in
an uncertain state. When she is uncertain, you help her by taking over firmly. Just as
when a child is uncertain about something, you say, "I'll tell you when to go .... Now!"
That's the same sort of thing. That is acceptable as help since patients have a long
history of having accepted help in such circumstances.
R: Direct authoritative suggestion works and helps when patients are uncertain, sitting
on the fence. They are not really following a suggestion, they are just accepting a
helpful push.

Ideomotor Signaling to Illustrate a Conflict Between Conscious and


Unconscious
E: Have we done anything to you of which you are unaware?
L: No.
E: Are you sure now?
L: Positively.
E: Have you ever seen a dispute between the conscious and unconscious mind? Now
watch your right hand.
If I have done a great deal with you this morning, your right hand will lift.
[Her hand begins to lift.]
Now, have I done a great deal with you this morning?
L: A little.
E: How much?
[Her hand begins to lift more rapidly.]
L: I don't know how to measure.
E: Do I know anything about you that I didn't know before?
L: Yes.
E: What?
L: You know that I went to Tunisia.
You know about some of my friends.
E: Could you tell me more?
L: We were just talking about it.
E: When?
L: Just a while ago.
Before I went to check the baby.
E: Can you tell me more than before?
L: I think maybe.
E: What is your hand doing?
L: Staying there.
E: What?
L: I think it is going up.
E: Why?
L: I think you did more with me than I thought.
(Pause)
E: Do you believe yourself or your hand?
L: My hand.
E: Have you forgotten what I did with you?
Consciously forgotten?
L: Yes.
E: Did you see anybody here in the office today?
L: Dr. Rossi.
E: Anybody else?
L: S.
E: Here you're teaching people by this conflict that their unconscious can do something
that they did not know about. She herself is furnishing that evidence.
R: So you're proving the existence of the unconscious to her.
E: In the presence of her conscious mind. You demonstrate that the conscious can
think one way and the unconscious another. You're going to have a chance to see and
prove within yourself that they think differently.
R: This is a highly important experience for patients to have: a demonstration of the
existence of the unconscious. They would thereby tend to become more amenable to
respecting and learning to relate to their unconscious. The therapist can then use
ideomotor signaling to detect and monitor any sort of psychodynamic conflict in this
way. There is a great need for clinically oriented research to develop new ways of
using ideomotor signaling and to evaluate its validity in different situations.
E: Just as when you demonstrate to patients their motivation about stopping smoking.
You ask them to put a few coins in a large bottle every time they would have lit up. A
quarter or two when they would have bought a carton. Pretty soon the people who
really want to quit see all that money piling up. That further motivates them to quit and
save all that money. It also proves to them that they do want to quit. That is their proof.
And when they fail to pile up the coins, that also is their proof that they don't want to
quit.
R: I see in this the possibility of a new therapeutic technique: Externalizing internal
processes and motivations so patients can relate to their inner dynamics in a concrete
and easily comprehensible way. What patients do externally with the coins can be a
reflection of what they do within themselves. The coins (or whatever other external
gauge you attach to internal process requiring change) function as a cognitive
feedback device altering the internal dynamics.
Ideomotor signaling appears to be an especially fine way of getting an assessment of
internal processes and motivations because the autonomous aspect of the ideomotor
movement is so convincing to the person who is experiencing it. In this example Mrs. L
actually believes the ideomotor movement of her hand more than her own conscious
ideation.

Double Bind Question:


Spontaneous Induction by Evoking Previous Trance Associations
E: Anybody else?
L: John.
E: You saw him?
L: Ummm.
E: Do you know you are in a trance right now?
L: No.
E: You really can go into a trance
effectively.
You can enjoy
using your abilities
R: She was awake; why was she going back into trance about here?
E: That's a thing you have to watch for. I noticed here that her face began to iron out
and that there was more of a fixed, unblinking stare and a lessening of body mobility as
she talked. Trance tends to be revivified when you review any hypnotic phenomenon
that has occurred in the subjects. They begin to relive what they are talking about and
begin to reexperience the trance, sometimes with and sometimes without their
knowledge. So then you say, "You don't know you are in a trance?" And they don't
know. So you've just taught them it's possible to go into a trance without knowing it.
R: That's a fantastic way of circumventing consciousness. E: Yes.
R: You revivify the trance by talking of trance events. Then you slip in the double bind
question, "Do you know you are in a trance right now?" An answer of "yes" means she
knows, an answer of "no" means she does not know she was in trance. Both answers
imply an acknowledgment of being in trance, only the knowledge of it was in question.
This reinforces trance further, so she recognizes that trance happened without her
consciousness knowing exactly why. This demonstrates how little the conscious mind
really knows. That is a very important learning because it enables her to recognize the
value of exploring her unconscious and its capacities, which are greater than her
conscious mind believes.
E: That's right.

Facilitating Unconscious Potentials:


Reinforcing Suggestions With Truisms
A process that you don't know you have
but abilities that are in your unconscious mind.
(Pause)
Your eyes are wide open
and adjusting so it won't get dark.
(Pause)
R: Here again you reinforce the idea that she has more ability than she believes. You're
always building up the unconscious and the greater potentialities that people actually
have while depotentiating their conscious mind with its limited beliefs about what can
be accomplished. You allow a brief pause for that message to sink in, but then, before
she can debate the matter, you immediately follow up with a self-evident truism about
her eyes being open. The obvious truth of this must evoke a "yes" within her that may
now in part reinforce the previous suggestion about her unconscious abilities. You like
to use statements of obvious truth to reinforce a previous suggestion. In your
interspersal technique (Erickson, 1966b) you use a series of obvious truths to surround
and thus reinforce every suggestion.

Posthypnotic Suggestion as Conditional Suggestion


E: I am now going to awaken you and I want you to be very surprised
you won't be able to bend your legs
E: I'll take credit for awakening her, but she takes credit for going into trance.
R: You're using the conditional suggestion format for this posthypnotic suggestion. The
suggestion ("you won't be able to bend your legs") is paired with an inevitable
occurrence ("I am now going to awaken you")

Set, Mental Flux, and Creativity


and you won't, will you?
(Pause)
You will see them but you won't be able to feel them
after I awaken you.
Agreed?
20, 19, 18, 15, 12, 10, 9, 8, 5, 3,
2,
1,
Are you ready to check on your daughter now?
L: No
(Pause)
E: How do you really feel?
(Pause)
E: These shifts from the negative (won't) to the positive (will) and sometimes the shifts
from positive to negative are keeping the patient in a constant state of movement. You
change the mind this way and back.
R: What's the value of keeping that constant movement?
E: You don't let the patients get a set. A mental set they can stay with.
R: Why not?
E: You don't want them with their mental set.
R: You keep them in movement so they will have to grasp onto your mental set?
E: Yes, the mental set you want to work with. You keep them in flux so you can
constantly orient them. But you aren't telling them, "I want you to pay attention to this
one thing."

Not Doing:
Generalizing Successful Posthypnotic Suggestion
L: My legs aren't awake.
They don't work.
E: How does that make you feel?
L: Awkward.
E: How does that make you feel when your legs don't work?
•L: Very limited.
E: It doesn't distress you, does it?
(Pause)
E: And you can do that with any part of your body any time it is necessary.
You can also use them any time it is necessary.
Any time you need to you will be in full possession of your abilities. Do you
understand that?
E: She has a master's degree and yet she uses this juvenile language here. Hypnotic
subjects do regress to simpler forms of thinking, feeling, and behavior. Simpler, more
youthful, less complicated forms.
R: There is even more to this posthypnotic suggestion of not being able to stand: you
are emphasizing not doing as a basic mode of hypnotic experience. You are giving her
an experience in the basic notion that in trance it is not the ego or the patient's usual
waking patterns that accomplish the hypnotic suggestion. In your paper on deep
hypnosis (Erickson, 1952) you said, "Deep hypnosis is that level of hypnosis that
permits the subject to function adequately and directly at an unconscious level of
awareness without interference by the conscious mind". In a simple and subtle way you
then generalize this successful posthypnotic suggestion on her legs to include any
other part of her body. You can greatly expand the area of any successful suggestion
by this simple phenomenon of generalization. It's a basic principle of learning theory as
well as hypnosis.

Posthypnotic Suggestion and the Reinduction of Trance


Do you think you are wide awake?
L: No.
E: That's right.
Close your eyes, and now this time you can awaken when I say, "one."
Now, one.
R: She is still in a trance because she is now carrying out your earlier posthypnotic
suggestion, "You won't be able to bend your legs." You have described (Erickson and
Erickson, 1941) how carrying out a posthypnotic suggestion reinduces a momentary
trance that can be utilized to reestablish another trance. This illustrates the care one
must occasionally take to awaken a subject when posthypnotic suggestions are used.
You noticed at this point that even though you went through a formal "awakening"
procedure by counting backward to one, she did not go through the typical awakening
movements of stretching and so on to reorient to her body. Therefore, she may not be
really awake. This is confirmed when she acknowledges the posthypnotic suggestion
with her statement about her legs not being awake. You therefore ask the double bind
question about whether she "thinks" she is awake. Any answer (yes or no) can imply
she is still in trance. She readily admits she is still in trance, so you simply go about
reawakening her again
[L now reorients to her body by moving her hands a bit, readjusting her legs, etc.]

Ratifying Awakening and Trance:


Ideomotor Movements and Dissociation
What is the different feeling you have now? (Pause)
L: I can do what I want, what my conscious mind is thinking about. Before, I could
think about things but I didn't really feel like doing anything about it.
E: That's right.
Anything else you would like to add?
L: Well, when I am in a trance, I am much more relaxed, feeling, sort of good,
except when I'm in a really deep trance,
like I tend to lose the sense of balance a lot and I feel slightly awkward.
R: Are you confirming she is now awake as well as ratifying the trance by asking her
what different feelings she has on awakening?
E: Yes. When you think about things, your body makes many ideomotor movements.
When children watch a movie, it's particularly obvious how they move about, thrusting
this way and that, acting out the scene they are watching. Here Mrs. L is saying, "I can
do what I want, what my conscious mind is thinking about. In trance I could think about
things but I really didn't feel like doing anything about." In ordinary waking state you
start thinking about scratching your head and you immediately get subliminal
movements in your fingers to do it. But in trance you can think about it without
subliminal movements.
R: In the ordinary waking state ideomotor movements are acted out, in trance they are
not?
E: Yes.
R: But how about finger signaling and hand levitation where you are using ideomotor
movements to initiate or deepen trance?
E: That is where the operator is using ideomotor movements in a special fashion. You
see a child watching a movie go through all the actions of what he is watching. But if
you put him in a trance to hallucinate the same movie, he will watch it without body
movements. He just sees.
R: So there is a dissociation between ideation and that motor behavior in trance. That's
why people are so quiet in trance. And that body stillness can be taken as a reliable
indicator of trance.
E: Yes.

Facilitating Creativity, Enhancement of Abilities


E: It's allright to feel that way, but you don't have to be off balance.
You can feel any way you want to, but you don't have to be any way that you don't
want to be.
It is nice to feel warm when you are cold.
It is nice to be cold when you are warm.
How is it when you feel wet all over?
L: It makes me feel dry.
E: Describe that feeling for me.
E: If she can't think about walking and do it in the ordinary way (in the awake state),
she loses her balance. (Erickson demonstrates how he cannot really think about
moving his paralyzed right arm without moving his left arm, which is not paralyzed.) I
can't get any minimal movements in the right hand, so I can't even feel how I would
move it if I could. Body feelings complement the thought of lifting the hand.
Now Mrs. L has lost her sense of balance because she lost her body feeling in trance.
R: She lost the sensory feedback the muscles give the mind, so she loses her sense of
balance.
E: That's right! But if you instruct the person to have those movements, he can. When
training a rifle team, I saw to it that they had certain types of subliminal body
movements that were conductive to accurate shooting. When a shot-putter got stuck on
the shot-put at 58 feet, I pointed out that his muscles did not know the difference
between 58 feet and 58 feet and one-sixteenth of an inch. Roger Bannister broke the
four-minute mile by reducing four minutes to 240 seconds because here 1/1000 of a
second counts.
R: This is all due to altering body feedback, altering the ideomotor connections. So you
can actually enhance physical abilities by breaking through conscious bias about
limitations.
E: Yes, unrecognized conscious bias.
R: Perhaps this is the secret of enhancing abilities in hypnosis: breaking through the
conscious bias of what our limitations are.
E: Yes. People say, "But I always eat cereal for breakfast! But we always have chicken on
Sunday." These are all conscious biases. You can broaden your activity, however, if
you recognize the bias. Experimentalists in hypnosis ought to know about the unlimited
number of biases that everybody builds up.
R: These biases are bedeviling their experiments, they are part of the source of
individual differences, etc.
E: People who accomplish a great many things are people who have freed themselves
from biases. These are the creative people.
R: You can define creativity as freedom from the biases of the past. If you can break
out of the sets of your forefathers, you can experience originality.
E: It's simply a conscious bias when people say they don't like cold. Sometimes it's
good to feel cold—especially when you're too warm.
R: So you're breaking through her conscious biases here and making her a more
flexible person with these instructions. Then she picks up your idea of flexibility when
she answers, "It makes me feel dry," to your query about wet.
E: Yes.

Induction of Trance by Removing Common Sets and Biases


L: It's kind of cold—no, I'm comfortable, but cold.
E: All right.
You can be dry now.
Now I am going to do something.
(Pause)
I want you to have a certain feeling
and a contrary knowledge.
I want you to feel naked from the waist up
even though you know
You are dressed from the waist up.
I want you to feel naked.
(Pause)
R: She has been awake up to this point, but now she's going back into trance in a
seemingly spontaneous manner here since she says "I'm comfortable." Why?
E: Because I have removed biases.
R: Really? You have removed biases and conscious sets so she automatically slips
into trance?
E: Biases are a part of our conscious living.
R: They keep us conscious? Would you go as far as that?
E: They are not just biases, they are part of the way we experience the world.
R: They are so much a part of the ground of our everyday experience that if we are
deprived of them, we suddenly lose our conscious orientation. And that results in
trance. So by simply removing people's biases and preconceptions, they tend to go into
trance. I find that so hard to believe!
E: You have given them a new kind of freedom in the trance state. With a few simple
words you restore a sense of freedom, and that belongs to the trance state. They then
begin to feel that freedom.
R: Freedom from conscious bias is characteristic of the trance state. Can we then call
this an indirect reinduction of trance by removing biases?
E: When you use the word "bias" it is so easily misunderstood. It is actually a common
set.
R: Removing a common set is what reinduces trance?
E: Yes. Another example is that when you have a subject talk about trance events and
feelings, he slips back into trance. That's what Jay Haley means when he says I take a
person in and out of trance without awareness of it.

Questions to Ratify Hypnotic Phenomena:


The Implied Directive
Do you want R to look at you?
L: No.
[Mrs. L now covers her breasts with her arms crossed over them.]
Do you want me to look at you?
L: No.
E: To answer that question she has got to feel naked.
R: So you are ratifying the hypnotic phenomenon of feeling naked. That's another
example of the implied directive by asking a question that requires a hypnotic
experience to have occurred!
E: That's right!
R: You know these things are so subtle that I actually feel a bit dizzy, a bit not quite all
here, in my effort to understand these things. I feel as if I'm in hypnosis right now. It's
so hard to understand these things. I guess my old mental sets are breaking and my
effort to grasp this new understanding makes me feel a little woozy!
E: She covers her breasts with her arms here. So I dodge all the difficulties of directing
her to being nude by simply asking that question.
R: You dodge all the doubts she might have had about whether or not she really felt
naked, etc.
E: I made it a fait accompli by asking that question.
R: You use that fait accompli a lot by the careful use of questions.
E: That's right.

Contradictions:
Conscious and Unconscious
E: There is a contradiction, isn't there?
L: I guess so.
E: It makes you uncomfortable, doesn't it?
L: Yes.
E: It is a delightful thing to be able to use your mind consciously
(Pause)
and unconsciously.
[A few personal and identifying sentences are omitted here.]
E: What is the contradiction? She is getting nude for me (obeying the hypnotic
suggestion), but she doesn't want me to look at her. She doesn't really get what I mean
when she answers, "I guess so."
R: Since she doesn't understand, you're again keeping her off balance.
E: I also discharge any great, discomfort by letting her know it's "delightful" to be
contradictory insofar as you're able "to use your mind consciously and unconsciously"
while it allows her to continue to be nude.
R: You let her be comfortable with the contradiction and at the same time reinforce her
being nude. You have her all tied up, she cannot move any which way but what you
suggest.
E: The pause between "consciously and unconsciously" effects a separation between
conscious and unconscious. It's delightful to use the conscious mind: to know you are
naked. You used your unconscious mind to become naked.
R: So you let consciousness do something and unconsciousness do something, and
they both cooperate in the task you're assigning.
E: That's right. She wants to be clothed. That's a conscious thing. She puts her arms
over her breasts: that's a conscious thing. But she is nude: that nude feeling is from her
unconscious, she got nude unconsciously.
R: She got nude unconsciously through a feeling process rather than figuring it out with
conscious logic. Feelings come from our unconscious.
E: Yes.

Breaking Through Self-Limitations:


Early Memory Recall
E: R would like to do something
which involves some rather complicated mental phenomena.
Are you willing to do that?
L: Okay, except I don't have a good memory of my childhood.
E: I'm glad you said that.
R: You're careful to get her permission here and give her a preparatory set for new
work. I notice you always do this when you introduce something new. L, in a manner
that is all too typical, gives expression to one of the ways her conscious bias limits her
ability to remember. You seize upon that self-limitation and seek to break through it.

Ideomotor Signaling to Facilitate Unconscious Potentials:


Depotentating the Limiting Sets of Consciousness
If your unconscious thinks you have a far better memory of your childhood than you
think,
[Mrs. L's hand does lift.]
E: You have a better memory of your childhood than you know about.
Do you mind looking back at your childhood?
E: L, close your eyes.
(Pause)
I would like to have you be puzzled by
something
that you can see.
I need some information first.
Did your father have a garden when you were very young?
L: Yes.
E: All right.
I would like to have you be puzzled by something that you can see on the other side of
a garden.
(Pause)
It's a little girl.
She is a nice little girl.
Maybe she is doing something she shouldn't be doing,
maybe she has dirty hands
or a dirty face.
I would like to have you clutch that child,
hold her and hold her.
R: Her hand lifting demonstrates the difference between her conscious and limited view
of herself and her unconscious's vaster degree of potentiality. In an indirect way you
are also depotentiating her conscious sets and assumptions by making a contradiction
evident: a contradiction between her consciously expressed opinion and her arm
levitation that implies a contrary opinion from the unconscious. Again you are
demonstrating how to precipitate a contradiction or conflict between conscious and
unconscious to keep patients off balance, in a state of creative flux, where they are
more able to shake free of their limiting sets to do more creative work with themselves.
Your suggestions that she be "puzzled" introduces a set for confusion that also will help
her break through her conscious limitations.

Generalizing Suggestions Evoking Specific and Personal Memories


I would like to have you watch her grow up.
(Pause)
And really watch that child grow up
(Pause)
and notice the changes in her.
There are going to be many changes,
many conflicting ideas,
believing, unbelieving,
some things that can't be shared with strangers,
and I want that little girl to grow up,
and after a while you will notice
that that little girl is really L.
So be interested in watching L.
(Pause)
Look at her with interest and appreciation,
and you can know anything
you wish about her,
but you will only tell those things to me that you can share with strangers.
R: You now embark on a series of very general suggestions that could apply to
anyone, yet they evoke highly specific and personal memories.
E: In real life, as one grows up through puberty, one naturally goes through periods of
great uncertainty: believing and unbelieving. "Some things that can't be shared with
strangers" guides her into very personal feelings and experiences without my telling her
to have a personal experience.

Trance Depth:
Unconscious Drifting Versus the Observer Function
Notice at times you forget that girl is L
(Pause)
and then you suddenly realize yes, it is.
(Pause)
R: This type of forgetting is a means of depotentiating consciousness further in trance.
She is encouraged to drift along on more autonomous and unconscious fantasy
currents until she again catches herself, until the observer function of the ego again
checks in, as it inevitably will. I wonder if this natural alternation between unconscious
drifting versus observing and in part controlling is responsible for the alternation in
trance depth that takes place spontaneously in hypnosis?

The Puberty Program


Notice that she is getting a different feeling about her body.
(Pause)
Notice that at times
that girl thinks to herself,
Is this really me?
Notice that at times you look at that girl
you can see yourself,
that really isn't me,
but yes, it is, but it isn't, but it is.
Have a very delightful time
(Pause)
E: When a girl begins to develop breasts or pubic hair, she goes through such feeling:
It is me but it isn't.
R: So without her being aware of it, you're guiding her into a reexperiencing of puberty
feelings.

Time Distortion in Life Review


and time is so long,
(Pause)
no matter how short the watch says time is,
it is really long. (Pause)
And since
you are going to share some of that knowledge with me,
and pick out certain definite things
that you can share with strangers,
but only those
that can be shared with strangers.
(Pause)
You have seen movies
of flowers opening
and in the same way you look at that little girl
growing up
from a little bud till full-bloom rose.
R: This is an example of your routine use of time distortion interpolated in a place
where it will obviously facilitate the work at hand. You then protect her by emphasizing
that she will share only certain things she can share with strangers.
E: There is another indirect association to puberty: womanhood opening up like a flower.

Awakening that Reinforces Inner Work:


The Implied Directive and Posthypnotic Suggestions
And when you have completed, really
looking at her, you will awaken
and tell us only those things that you are willing to share.
[After a minute or so L awakens and stretches her arms.]
E: Hi, L.
L: Hi.
R: It's interesting how you make awakening contingent upon completing that inner task.
That's a form of the implied directive that includes a posthypnotic suggestion to tell only
what she is willing to share.
E: That's right.
R: You know she's going to have to awaken sometime, and she might even be eager to
awake . She will thus do the inner work so she can wake up. When she finally does
actually awaken, that tends to reinforce the fact that inner work has been done.
E: Yes, it's her admission that the inner work has been done. Awakening her in this
manner compels her to do it, but I haven't verbally said, "Now you do that!" She does
not recognize that I have compelled her.

Trance Termination and Amnesia


[As L awakens, Erickson greets her with a cheery "Hi" and then encourages her to
recount some of her early experiences that she recovered while in the trance state.
After about 10 minutes of this casual recounting, S, who had been in a trance of her
own, spontaneously awakens herself. On questioning, it is learned that S felt a little bit
bored, perhaps a bit resentful that L had been getting all the attention, and she just felt
like awakening to join us. She had awakened herself by saying silently to herself, "I
am going to count to three and then awaken feeling refreshed and alert," and she did
exactly that. She is much too polite to complain to Erickson, but she is in a quietly
doubtful and questioning mood about the whole procedure.
E: This cheery "Hi" on awakening is because "Hi" belongs to the world of
consciousness. I'm thereby telling her to be wide awake and forget all about that
unconscious activity.
R: By so dismissing it you're effecting an amnesia except for those things you said she
could share.
E: Yes, I'm causing an amnesia by implying "that's all over and done with. Now let's go
on to something else."

THE IMPLIED DIRECTIVE


The "implied directive" is a label we are proposing for a fairly common type of indirect
suggestion that is in current use in clinical hypnosis (Cheek and LeCron, 1968). The implied
directive usually has three parts: (1) a time-binding introduction, (2) the implied (or assumed)
suggestion, and (3) a behavioral response to signal when the implied suggestion has been
accomplished. We may thus analyze an implied directive from this session as follows:
As soon as you know
(1) A time binding introduction that focuses the patient on the suggestion to follow

only you or I, or only you and my voice are here


(2) The implied (or assumed) suggestion

your right hand will descend to your thigh.


(3) The behavioral response signaling that the suggestion has been accomplished.

An implied directive frequently used by Rossi to end a hypnotherapeutic session is as


follows:
As soon as your unconscious knows
(1) A time-binding introduction that facilitates dissociation and reliance on the
unconscious.

it can again return to this state comfortably and easily to do constructive work the
next time we are together,
(2) The implied suggestion for easy reentry to trance phrased in a therapeutically
motivating manner.

you will find yourself awakening feeling refreshed and alert


(3) The behavioral response signaling that the above suggestion has been
accomplished.
When the behavioral response signaling the accomplishment is an inevitable response
that the patient wants to happen (as in the above examples), we have a situation where the
behavioral response also has motivating properties for the accomplishment of the
suggestion. The behavioral response signaling the accomplishment of the suggestion takes
place on an involuntary or unconscious level. Thus the unconscious that carries out the
suggestion also signals when it is accomplished.
The implied directive engenders a covert state of internal learning. It is covert because
no one can tell it is occurring since it is a series of responses taking place entirely within the
subject, frequently without conscious awareness and usually not remembered after trance.
Therapist and patient only know it is completed when the requested automatic response
(e.g., finger signaling, head nodding, awakening from trance) takes place, signaling the end
of the internal state of learning.
The implied directive is thus a way of facilitating an intense state of internal learning or
problem solving. We may suppose that all of a subject's available mental resources (e.g.,
stored memories, sensory and verbal associational patterns, various forms of previous
learning, etc.) are marshalled toward a creative state of learning and problem solving. Since
recent experiments in the neurophysiology of learning suggest that new proteins are actually
synthesized in the appropriate brain cells during learning (Rossi, 1973a), we may speculate
that the implied directive facilitates the internal synthesis of new protein structures that could
function as the biological basis of new behavior and phenomenological experience in the
patient.
The implied directive is particularly interesting because of its similarity to the technique of
biofeedback. In most forms of biofeedback an electronic device is used to signal when an
internal response has been accomplished. With the implied directive the patient's own overt
and autonomous behavioral response is used to signal when the internal response has been
accomplished. The formal similarities between them may be listed as follows:
1. Consciousness is given a task it does not know how to accomplish by itself.
Raise (or lower) your blood pressure 10 points.

Warm your right hand and cool your left.


Increase the alpha of your right cortex.
Decrease the muscle tension in your forehead.
2. Consciousness is given a signal enabling it to recognize when any behavior changes
are being made in the desired direction of response. In biofeedback this is accomplished by
an electronic transducer that measures the response (blood pressure, body temperature,
alpha waves, or muscle tension in the above examples) and makes any change in this
response evident on a meter that allows the subjects to monitor their own behavior.
In the implied directive, by contrast, the patient's own unconscious system serves as the
transducer indicating when the desired internal response (blood pressure change, body
temperature, etc.) has been made and translates it into an overt behavior signal that
consciousness can recognize.
The advantages of the implied directive over biofeedback are obvious. The latter is a
fairly cumbersome technique that requires sophisticated and expensive electronic equipment.
It is limited to those responses that can actually be measured. By contrast, the implied
directive requires no equipment and is limited only by the ingenuity and imagination of both
therapist and patient. Although no comparative studies have been made as yet, one might
expect that the electronic equipment of biofeedback might ensure a greater reliability of
control than is possible with the implied directive. For this, indeed, is the major problem in
utilizing any method of hypnosis: the relative reliability of response between different
individuals and within the same individual on different occasions. It may well be that this
reliability problem can be dealt with in part by utilizing this analogy with biofeedback. The
reliability of biofeedback is due to the reliability of the signaling system provided by the
electronic instrumentation. Hypnotic procedures can be made more reliable by having
patients remember and report experiential and behavioral changes that initiate or accompany
the desired hypnotic response. These changes may then function as signals to reinstate the
hypnotic response on another occasion. In this case hypnosis and biofeedback share
another common aim: to establish a connection between a conscious thought or behavior
and a previously nonvoluntary response.

Exercises with the Implied Directive


1. The implied directive has evolved in clinical practice, but there is no research data
that has experimentally validated its usefulness. Can the reader devise implied directives that
can be validated experimentally in a controlled and objectively repeatable manner?
2. Devise implied directives that will facilitate the experience of all the major hypnotic
phenomenon.
3. Devise implied directives that will facilitate the internal learning of therapeutically
useful goals (e.g., freeing the unconscious from the limitations of a particular patient's ego
programming to find a new solution for a problem).
4. Since the implied directive includes an involuntary signal that a suggestion has been
accomplished, it can be used in place of "challenges" to test the effectiveness of trance work.
In the older, classical approaches to trance training the operators "tested" and "proved" the
depth and validity of trance and the strength of their suggestions by "challenging" subjects to
try to open their eyes or unclasp their hands when they had been given suggestions that they
could not do so. If the subjects were not able to open their eyes, then they passed the
challenge and the validity of trance was established. The implied directive accomplishes the
same purposes in a much more constructive and permissive manner. It leaves the locus of
control within the patient, where it belongs, rather than fostering the illusion of the therapist's
control. It is thus a valuable indicator for both subject and therapist that a desired response is
indeed taking place. The therapist can now learn to devise implied directives as indicators of
any stage in the development and accomplishment of suggestions requiring internal
responses (memories, feelings, sensations, etc.) not otherwise open to the therapist's
observation.

QUESTIONS THAT FOCUS, SUGGEST AND REINFORCE


One of the most surprising aspects of approach is his use of questions to focus attention,
to suggest indirectly, and to reinforce all at the same time. Questions seem so innocent in
everyday life. When other people question us, it is frequently from their own need, and the
question implies that we know something and are quite fine to be helping them. Questions
asking for help, directions, advice, and so on are all of this category and are most useful for
focusing attention.
Another useful category of questions concerns abilities: Can we do such and such? This
ability question frequently has strongly motivating properties from many years of effort in
childhood, adolescence, and young adulthood to meet a developmental challenge
successfully: "I'll try, and I bet I can!" These ability questions are therefore useful in
motivating patients provided they are not overwhelming in their demand. We must take care
because questions can also be piercing and destructive, as when they are experienced as
the merciless stings of an examination situation or inquisition.
Recent research (Sternberg, 1975; Shevrin, 1975) indicates that when questioned, the
human brain continues an exhaustive search throughout its entire memory system on an
unconscious level even after it has found an answer that is satisfactory on a conscious level.
The mind apparently scans 30 items per second even when the person is unaware that the
search is continuing to take place. The results of such searches on an unconscious level are
evident from many familiar experiences of everyday life. How often do we forget a name or
an item only to have it pop up all by itself only a few moments later, after our conscious mind
has gone onto something else? How often are we consciously satisfied with a solution only to
have fresh doubts and perhaps a better answer come up autonomously a short while later?
The fact that such unconscious search and cognition are carried out in response to
questions even after the conscious mind is apparently satisfied and otherwise occupied is a
verification of Erickson's early research supporting the then controversial view that the mind
could be simultaneously active on two entirely separate and independent tasks— one on a
conscious level and another on an unconscious level (Erickson, 1938; 1941). This activation
of unconscious resources is the very essence of the indirect approach, wherein we seek to
activate and utilize a patient's unrecognized potentials to evoke hypnotic phenomena and
therapeutic responses.
As usual demonstrates and indirect approach even in his use of questions, which
typically structure the patient's internal associations by implication. Questions are frequently
implied directives. They are often used to depotentiate conscious sets so the patient will be
more open to new response possibilities. Let us analyze a few examples of Erickson's
questions. It will be found that it is almost impossible to neatly classify these questions
because even the simplest are very complex in their implications and effects.
Which hand is lighter?
Focuses attention on hands. Indirectly suggests one will be lighter and may levitate.
Reinforces lightness and possible levitation as an adequate response. It is an implied
directive insofar as it requires a hypnotic response to be answered adequately. Illusory
choice and double bind are also operative because one is being bound into making a
hypnotic response whichever hand feels lightest. This question indirectly depotentiates
consciousness because it is no unusual that the "normal" and habitual frameworks of
ego consciousness cannot cope with it, so the patient must wait for an unconscious or
autonomous response.
Why did John just leave?
This question in the context of this session where Mrs. L was hallucinating John serves
primarily as an indirect suggestion to cease hallucinating. It works by implication and
refocuses attention.
Do you want Dr. Rossi to look at you?
In the context of this session where Mrs. L is hallucinating herself as naked from the
waist up, this question strongly ratifies the hallucinatory experience with an implied
directive that she show some response to being naked in front of a relative stranger
(she covered her breasts with her arms).
Do you enjoy
(pause)
not knowing where you are?
This is an indirect, compound suggestion that gains its potency from many sources. It
is compound because it asks two questions at the same time: Do you enjoy? You do
not know where you are? It is so difficult to answer such a double question that the
patient would frequently rather just go along with it and "enjoy not knowing where he
is." The use of the negative "not knowing" is a further source of confusion that is
frequently too difficult to figure out, so the patient goes along. "Do you enjoy" indirectly
suggests pleasure and is thus reinforcing.
It is evident from these analyses that we are only beginning to make a beginning in our
understanding of language in general and questions in particular. The hypnotherapist would
do well to make as thorough as possible a study of that branch of semiotics known as
pragmatics, the relation between signs and the users of signs (Morris, 1938; Watzlawick,
Beavin, and Jackson, 1967; Watzlawick Weakland, and Fisch, 1974).

Exercises with Questions for Analysis


1. Perform a similar analysis on the following questions as well as all others you find
interesting in the inductions of this volume.
Would you like to enter trance now or later?
Where does your body experience its greatest comfort?
Can you say, "something?" (Note the use of this question as a test of literalism.)
Do you really understand? (The vocal emphasis is on "really.")
Can you enjoy relaxing and not having to remember?
Can your unconscious deal with that problem?
Do you feel comfortable not knowing who I am?

QUESTIONS FOR INDIRECT TRANCE INDUCTION


One of the most useful forms of suggestion is the question that (1) fixes and focuses
attention while (2) helping subjects to reach into their own associative matrix to uncover
useful responses that (3) can be structured into new behavior patterns. Erickson frequently
induces trance and carries out an entire hypnotherapeutic session with a series of questions.
1. What kind of trance would you like to experience?
2. How long will it take you to go into that trance?
3. How will you know you are beginning to experience trance?
4. Now do you really think you are still fully awake?
5. How much of a trance do you feel you are in already?
6. How soon will your trance deepen?
7. You will let me know when it is deep enough, will you not?
8. What would you now like to experience in this trance as it continues to
deepen? Or would you like it as a surprise? Sooner or later?
9. Will you let your hand (finger, head) move when it feels warm (cold, numb,
etc.)?
10. And you don't know how much of that numbness you would like to maintain
after you awaken, do you?
Each of these questions evokes associative responses to different aspects of trance
experience within the patient. The effect of the first three is to reintegrate previous trance
experiences as well as heightening patients motivation for their current experience.
Questions 4 and 5 help patients assess their current status and help make the transition from
awakedness to trance. Questions 6 and 7 complete this transition and set up a signaling
system so that patients can let the therapist know when a trance of sufficient depth has been
achieved. Questions 8, 9, and 10 are all variations that can be used to explore the evocation
of virtually any hypnotic phenomena or posthypnotic response. Questions are thus a fail-safe
approach to trance experience. The question, more than any other hypnotic form, appears
automatically to evoke partial aspects of the phenomena in question so that they may be
expresses as a possible hypnotic response.

THE FRAGMENTARY DEVELOPMENT OF TRANCE


We feel it is better to induce a trance by fragments than by demanding the whole all at
once. The questioning approach allows patients to experience trance by degrees. It also
allows the therapist to continually monitor the process and know where the patient is all the
time. It is similar but not identical with Vogt's fractionation technique (Weitzenhoffer, 1957;
Kroger, 1963) and the process "heteroactive hyper-suggestibility" (Hull, 1933) whereby
following one suggestion tends to increase the probability of following another.
R: Why is it better to induce a trance by fragments?
E: You induce a small fragment of the trance and then another. Then you can connect
those two.
R: Different fragments of trance are developed by questions that function as waking
suggestions? Each waking suggestion that is accepted adds another fragment of trance?
E: Yes, and then you relate them together. First you develop a catalepsy of the arm.
Then you add: "And the numbness, do you notice that? "And you can't move your eyes from
your hand? "All you can see is your hand? "And all unimportant sounds have dropped out?"
R: These questions successively build the trance by adding a possible experience of
analgesia or anesthesia, immobility of the eyes and head and a negative visual and auditory
hallucination for unimportant background details.

Exercises Utilizing Questions as Suggestions


1. Write out a complete induction using only question for the following approaches to
trance:
a. Hand levitation
b. Eye fixation
c. Relaxation
d. Any other favorite approach such as visualization, etc.
2. Formulate series of questions that will focus a subject's attention and associative
processes in such a manner that an experience of each of the classical hypnotic phenomena
will be facilitated.
3. Formulate a series of questions that will focus a patient's memories and
associations in a manner that will facilitate a therapeutic response.
4. The question approach to trance induction is very similar to the introspective
approaches that are utilized in many diverse schools of psychotherapy. The active
imagination of C. G. Jung (Jung, 1963; Rossi, 1972), the meditation methods of Assagioli's
psychosynthesis (Assagioli, 1965), and the dialogues of the gestalt approach (Perles, 1969)
all focus the individual's attention on inner realities. Thus, they are trance inducing, even
though their originators usually do not recognize it. Such methods may be considered indirect
approaches to trance even though they are not labeled as hypnosis. The essential identity
between periods of introspection and trance was demonstrated by Erickson in his early
research with Clark L. Hull (Erickson, 1964), when he found that groups of subjects asked to
perform a task in introspection underwent behavioral and subjective experiences that were
similar to those they had when they went through a classical hypnotic induction.
It would be instructive to the beginner in hypnosis to give subjects tasks in introspection
and imagination and then ask for their subjective comparisons of these inner experiences
with those of a classical hypnotic induction. What similarities are noted in their outer
behavior? The relation between such introspection-imagination approaches to trance and
imagination (Sheehan, 1972) are the subject of much current research (Hilgard, 1970).

DEPOTENTIATING CONSCIOUS MENTAL SETS:


CONFUSION, MENTAL FLUX, AND CREATIVITY
R: You keep patients constantly in flux, slightly off balance, so they will continually grasp onto
whatever orientation you provide?
E: Yes.
R: That is one of the creative states within hypnosis; that state of constant flux wherein the
patient grasps the orientations you provide.
E: That's right.
R: This is in contrast to the situation where you allow patients to remain quiet by themselves
in a trance (Erickson, 1955) to work out their own solution to a problem in their own way.
E: When a person goes into a trance, you bounce him around and keep him whirling and
then you tell him to work quietly on that problem. You have first detached him from his
conscious mental sets. You have broken the connections that might have been stopping him
from working on his problem. That is a very important thing.
R: You break their habitual mental sets and the conscious biases that prevented them from
solving a problem and then orient them toward creative inner work.
E: People always have that tendency to put off working on a problem to tomorrow. But you
make tomorrow today by breaking those conscious sets and keeping them in a state of flux.
R: That is part and parcel of the confusion and the surprise techniques as well. All these
approaches depotentiate the limitations of conscious sets.
In this conversation Erickson clearly expresses a major aspect of his work in facilitating
problem solving and creativity. Earlier in the third session we saw that a flow diagram of
trance induction went as follows:
DIMMING OF OUTER REALITY

CONFUSION

RECEPTIVITY TO CLARIFYING SUGGESTIONS

TRANCE WORK PROPER


In this section Erickson elaborates further on the significance of confusion. Confusion
("you bounce him around and keep him whirling") is used to detach people from their
"conscious mental sets." You have broken the connections that might have been stopping
them from working on their problem. A patient is a patient because of erroneous mental sets
and limited frames of reference. Erickson continually seeks to break through these rigid
limitations to initiate a state of mental flux that may release the patient's creative potential.
Thus, confusion becomes a major tool for breaking rigid mental sets and initiating a
creative process. An entirely spontaneous example of this process occurred in the
commentary of this session, where Rossi admits to feeling "woozy" trying to break through
his own mental limitations to understand what Erickson was trying to teach. This feeling
actually occurred many times. The breaking of Rossi's habitual frames of reference together
with the complexity which which Erickson expresses himself was sometimes enough to
induce a hypnotic atmosphere. The complexity of Erickson's thought, it should be noted, was
not due to its abstract nature, but to his habitual use of indirection, questions, and
implications that continually turn over a listener's associative processes in ways that are
experienced as unusual and perhaps not self-directed (and therefore hypnotic).
Many of the verbal forms that Erickson uses to initiate confusion to break through a
patient's erroneous conscious sets are already familiar to us: the use of provocative
questions, implications, double binds, the surprise, not doing and not knowing.
At the simplest level Erickson softly and insistently reiterates all the things a patient does
not need to do or know. He is actually telling the patient's consciousness that it can relinquish
its usual control and direction and permit unconscious and autonomous processes to take
over. The whole process of trance induction is designed to relax these habitual sets of
consciousness. The trance deepens, and patients are able to break out of the learned
limitations of their usual mode of consciousness to the degree that they give up what they
know.

Not Knowing, Not Doing


You don't need to listen, your unconscious can respond on its own.
You don't need to know [whatever] for when the occasion arises, your unconscious
will supply that knowledge.
You don't know when you are going to change your rate of breathing [or whatever].
[To a restless patient] You don't know exactly when you will feel a need to move again.
You don't need to know where your hands [or whatever] are.
I would like you to learn
that no matter what any person believes,
your belief,
your unconscious belief, your unconscious knowledge,
is all that counts.
In the course of
living from infancy on,
you acquired knowledge,
but you could not keep all
that knowledge in the foreground
of your mind.
Note from the induction section how these last two suggestions lead up to Erickson's
suggestion for forgetting.
Closely related to not doing and not knowing are the related hypnotic forms of Losing
Abilities, The Negative, Doubt, Contradictions, and The Apposition of Opposites. We will now
take up each of these in turn.

Losing Abilities
Erickson likes to phrase suggestions in the form of Losing Abilities because it is easy to
experience, it is compatible with the basic nature of trance, and it is a rather impressive
demonstration of trance as an altered state. Losing abilities tends to depotentiate one's usual
everyday reality orientation and thus make one more receptive to altered modes of
experiencing.
It will be interesting to experience that moment when you can no longer hold your
eyelids open.
You can lose the ability to lift your right hand from your thigh. And will it be surprising
when you find you cannot stand up?

The Negative
Erickson has studied the use of the negative in great detail. He admired an actor who
could say "no" in 16 different ways to express 16 different shades of meaning from "absolute
no" to agreeable acquiescence. A few examples are as follows.
Won't you?
When expressed with a doubting tone of voice, this has a negative meaning—"You
won't." It is used only when you don't want a subject to do something.
You will, will you not?
This is a use of a negative word: "not?" is turned into a positive by being enunciated
with a questioning inflection. Erickson feels this phrase meets a subject's need for a
negative to balance the positive "you will" that comes just before it; this sentence is
thus example of his apposition of opposites.
Research has indicated that it is much more difficult to comprehend negative
formulations (Donaldson, 1959). The use of the negative, therefore, tends to depotentiate
consciousness. In trance, when one would rather "not do" it is easier just to go along with a
suggestion than try to figure out all its implications.
Erickson also believes that the use of the negative is another way of maintaining
psychological balance and compensation as we will discuss later in the apposition of
opposites. The use of the negative also enables the therapist to proffer a negative onto which
a patient's resistance may be discharged and displaced. The use of negatives may thus be
regarded as another approach to dealing with the "resistant" patient. The use of negation
with such patients actually utilizes their own negativity in a manner that can discharge its
destructive aspects and redirect it into constructive channels.

The Negative for Reverse Suggestion


Another basic use of the negative is for indirect or reverse suggestion. On one occasion
a patient insisted that he would not awaken. Erickson accepted that, while admitting it would
be inconvenient since he had other patients to see that day. Then with utter sincerity
Erickson mentioned that he hoped the patient would not have to go to the bathroom, since
that would awaken him. Of course, the patient soon found that he did have an inexplicable
need to use the bathroom and thus had to awaken. Another reverse suggestion might have
been, "Fine, you can try to stay in trance and do not awaken." The word "try," said with a
subtly doubting tone together with the implied effort it will require not to awaken, has the net
effect of actually awakening the subject.
In the reverse situation, when we want to enhance the possibility of trance, we might say,
"Try to stay awake, just try and do not go into trance." The subject usually resists trance
heroically for a few minutes till he is exhausted from the implied effort and falls by default into
trance. These effects of negative suggestion were early described by Baudouin (1920) as the
law of reverse effort: the more one tries to resist a suggestion, the stronger he feels
compelled to carry it out. Weitzenhoffer (1957) has described this law of reverse effort" as a
pseudo-law. There is actually no clinical or experimental data that indicates there is an
intrinsic and necessary relation between "trying to resist" and a "compulsion to carry it out."
Weitzenhoffer (1975) believes the effectiveness of such formulations is due to their
containing an implied suggestion to do the exact opposite of what is purportedly suggested.

Doubt
The use of doubt is a subtle process that Erickson frequently conveys with a doubting
tone of voice on key words (placed in italics in the examples below). Erickson usually
capitalizes on the minimal and perhaps unrecognized doubt already experienced by a
patient. His statement about this doubt is thus as much a truism as a suggestion. Whatever
the doubt, it does place the person in a less stable position and thus propels one into a
search for more structure and certainty. Erickson, of course, then provides therapeutic
suggestions that will help restructure the patient in a satisfactory manner.
Do you really understand? means, "distrust your conscious understanding".
And you will really understand means the same as, "You don't really understand".
Do you think you are wide awake? implies, "You are not awake."
You are quite certain of yourself now, are you? implies, "You are not."

Contradictions
Revealing contradictions within patients' minds demonstrates the inadequacy of their
usual beliefs and prepares the way for a positive attitude toward an experience with
therapeutic trance. Erickson makes something of a game of this as he helps a patient to
realize contradictions between thought and feeling and, of course, between the conscious
and unconscious. He frequently uses ideomotor movements as a proof of these
contradictions. Thus, when a patient protests that an important memory is not available,
Erickson may establish a convincing contradiction, as follows:
If your unconscious thinks you have a better memory [feeling, thoughts, or
whatever the patient has doubts about], your hand will lift.
When the hand does lift autonomously, it tends to convince the patient that with further
hypnotic work the memory may soon become available.
When a patient doubts whether trance has been experienced, Erickson will use
ideomotor movements to establish it.
Your conscious mind may doubt, but if your unconscious knows you have
experienced trance, it will let your head nod slowly in the affirmative.
Erickson can thus frequently utilize the obsessive, ambivalent, and doubting aspects of a
patient's ideation in a creative manner. The obsessive-compulsive personality can be
understood as one laden with contradictions between the conscious and unconscious. These
contradictions can be explored to establish rapport and cooperation between the various
tendencies within the personality.

Apposition of Opposites
Another of Erickson's indirect forms of hypnotic suggestion is his penchant for the close
juxtaposition, or apposition, of opposites. This seems to be a basic element in his confusion
techniques, but it also may be a means of utilizing another natural mental mechanism to
facilitate hypnotic responsiveness.
In the second Session Erickson illustrated the careful balancing, or apposition, of the
opposite processes of remembering and forgetting. Kinsbourne (1974) has discussed how
the "balance between opponent systems" is a basic neurological mechanism that is built in
the very structure of the nervous system. What we are labeling as the "apposition of
opposites" may be a means of utilizing this fundamental neurological process to facilitate
hypnotic responsiveness. In this case Erickson was apparently balancing the opponent
systems of remembering and forgetting without the patient making a conscious effort to do
either. Another apparent balancing of these opposites that is actually a double bind is as
follows:
You can forget to remember or remember to forget.
Other modalities for the apposition of opposites are in lightness and heaviness, warmth
and coolness, relaxation and tension, etc.
As your hand lifts, your eyelids will feel heavy.
This juxtaposition of lifting and lightness with heavyness utilizes the balance between
opponent systems in another way. If we emphasize lightness and levitation, then we are
shifting the subject out of equilibrium so there will develop within the subject a
countertendency to balance and oppose the lightness with heaviness. This natural
countertendency could eventually defeat the levitation suggestions. If we utilize this natural
countertendency to heavyness by suggesting another response where it can be useful
(eyelids heavy), however, we are actually utilizing the balance between opponent processes
in a way that will facilitate two hypnotic suggestions. It is a way of offering multiple tasks that
can reinforce each other. Other examples of the planned use of such apposition is as follows.
You can remain comfortable immobile until the urge to move takes your hand
across the page writing automatically.

You may either see an unexpected image in the crystal ball or not see the ball at
all.

As your hand becomes warmer, your forehead can become cooler. As you make
that tight fist, the lower part of your body can relax.
Exercises with the Apposition of Opposites
1. Formulate suggestions utilizing the apposition of opposites warmth and
coolness, tension and relaxation, anesthesia and hypersensitivity to touch. An interesting use
of the latter for a refractory case of dental anesthesia is described by Erickson (1958). After a
number of unsuccessful efforts by others Erickson was able to facilitate an effective oral
anesthesia for dental work by first suggesting that the patient's left hand would become
hypersensitive to all stimuli and needed to be carefully protected at all times. This was in
keeping with the patient's fixed belief that dental work was always associated with
hypersensitivity. Erickson simply displaced that hypersensitivity from the mouth to the hand.
Erickson comments, "When this rigid understanding was met, dental anesthesia could be
achieved, in a fashion analogous to the relaxation of one muscle permitting the contraction of
another."
2. Conceptualize other opponent processes in the sensory, perceptual, and cognitive
realms that can be used to facilitate hypnotic responsiveness.
3. Formulate apposition of opposites that could be utilized to facilitate all the classical
hypnotic phenomena.
SIX

Facilitating Hypnotic Learning


The relations between the conscious and unconscious and Erickson's means of dealing
with them are explored in this session. It is apparent that Erickson, like most pioneers in
depth psychology, really believes in the value of the unconscious as a useful concept in his
daily work with people. He carefully points out how the conscious and unconscious each
have their own interests and how successful hypnotic work frequently depends upon
appealing to both. As usual, he has an indirect approach for dealing with this problem.
Erickson believes that analogies are a means of simultaneously appealing to the conscious
and unconscious. As such, analogies are a basic tool for facilitating hypnotic learning.
Because of this, Erickson employs a rich repertory of analogies drawn from everyday life.
It will be seen that many of these analogies are about the perceptions and experiences of
childhood; the child's ways of functioning are closer to unconscious, which Erickson is trying
to facilitate in trance work. He likes to use examples from his own experience because he
knows them best, and his sense of conviction helps mobilize similar experiences within the
patient. His analogies always fixate (or bore) the attention of consciousness while
simultaneously instructing the unconscious. The conscious mind does not know how to do
certain things. That is why the person is in therapy. The individual's unconscious does have
the resources for doing what is necessary. Analogies are frequently an effective approach for
mobilizing these unconscious resources.

Expectancy and Giving up Preconceptions


E: Do you have any questions?
S: I had a couple of questions, but I can ask them later. E: Ask them now.
S: I still wasn't clear yesterday why you didn't follow through when you put me in a
trance. It wasn't clear.
You said you wanted me to experience it or something?
I understand that a hypnotherapist should experience a trance, but I wasn't quite clear
in my mind what you were doing,
but maybe it isn't important for me to know.
E: You never completely satisfy your audience. You leave them wishing for more.
That's what is happening here. She is asking, "Why didn't you do more with me?" That
impresses upon them that they really do want more.
R: You have induced a situation wherein she is asking you for more and may thus
break through some of her limitating preconceptions. The fact that she finally admits
that "maybe it isn't important for me to know" suggests she may be giving up some of
her reliance on consciousness.

Separating the Conscious and Unconscious:


Relying on the Unconscious
E: I wanted your unconscious mind to have the liberty of doing something while your
conscious mind was filled with other things.
and you wouldn't know your unconscious was active because you are being so
interested in conscious activity.
S: Yes, what was going on here.
I was curious about what I did with L.
Couldn't that be considered a kind of hypnosis having her relaxed and concentrated
on being in a different place?
E: Yes.
S: I think that can only be done by a good subject.
E: A good subject or a sophisticated one? What other questions have you?
S: That's all.
E: I'm making it apparent here that there are two sets of interests, and the unconscious
is going to have its interests.
R: You're carefully pointing out the separation of conscious and unconscious interests.
E: You can't make that too obvious or too plain. You have to rely on the unconscious.

Hand Contact in Trance


[S gets ready to enter trance, but her hands are neatly folded together in her lap.]
E: One of the things that I found very important is, don't let the hands remain in
contact with each other. Just how the contact of the hands interferes, I don't know.
(Pause.)
Now go all the way.
(Pause.)
E: In folk language, "You have to hang together." When your hands touch each other,
they tend to hang together. But you want an openness to stimuli—not something that is
hanging together and excluding.

Unconscious Learning
Your unconscious learned a lot yesterday.
(Pause.)
It also learned
that
we could learn a lot
without
intruding upon the personality.
(Pause.)
All subjects,
whatever their degree of sophistication,
are uncertain that they can do
everything,
and yet
in their personal history
they can.
(Pause)
I have hunted for a book in a bookcase
under the impression,
within the frame of reference,
that it was bound in red.
I was unable to find it.
I could resort to reading all the titles of every book
and still not be able to find it
even though I read all the titles.
The title had no meaning
because my reference was red
instead of blue, which was the correct color.
E: "Your unconscious learned a lot yesterday."
(Erickson and R here discuss the case of Mrs. K, whose active and conscious mind
derogatorized her unconscious' very acute "literalism" while in the trance state. So
acute was her literalism that it even surprised Dr. Erickson. That literalism was an
"accomplishment" of the unconscious, but Mrs. K's conscious mind regarded it as
error.)
E: The conscious mind downgrades unconscious accomplishments, and you can't
allow that downgrading to continue because conscious emotions filter down to the
unconscious.
R: You mean the negative sets of consciousness can inhibit unconscious potentials?
E: The unconscious is going to be protective of consciousness. R: You mean it will go
along with the conscious bias?
E: It's going to try to reassure the conscious mind with, "You don't have to be depressed if
you didn't do things." The unconscious won't say, "You did something even though you
didn't know it (e.g., Mrs. K's acute literalism). It doesn't function that way. It just says,
"You don't have to worry because you failed."
R: That is how the unconscious protects the conscious mind?
E: The unconscious mind, with all due respect, does not tell the conscious mind,
"You're wrong?"
R: It says instead?
E: "You don't have to feel bad about it." So you must see to it that the conscious mind
gets the impression, "I only think I've failed."
R: That's how you correct the conscious mind.
E: Yes. With Mrs. K. we had to assure her that I, Dr. Erickson, failed in my instructions
to her and that her acutely literal response was a success as a hypnotic response on
the part of the unconscious.

Objectivity:
Breaking Conscious Frames of Reference
That has happened to me many times.
It seems true to others.
Others who haven't been in a trance.
(Pause)
Now why wouldn't I have seen a book covered with blue when I read its title?
(Pause.)
Because we all have the ability not to see when we are wide awake,
and in trance state
that ability can be called upon at any time.
(Pause.)
E: This illustrates the biasing influence of a conscious set on true knowledge.
R: You're trying to tell S with all these examples, "Give up conscious biases and sets."
E: Don't let conscious frames of reference occlude your vision.
(Erickson here gives many everyday examples of how conscious sets, e.g., rose-
colored glasses, continually interfere with an objective perception of things. What is an
objective perception? Seeing from many points of view to get a rounded picture.)

Negative Hallucination Training


There are many times in the past when you haven't seen something that was there;
you haven't felt things that could be felt.
R: Now you're shifting into suggestions that may lead to an experience of negative
visual hallucinations: not seeing, hearing, or feeling.

Utilizing Everyday Experiences to Evoke Hypnotic Phenomenon


It is a very common experience
to develop a hypnologic state
and arouse in the morning from your sleep and not know where you are.
Everybody has the experiences of deja vu.
(Pause.)
Those who have seen something before think they have as if it really happened to
them.
Hearing something before that you really haven't,
of being someplace where you haven't been
but still think you have been there.
Everybody has those experiences.
Transforming a familiar experience
into an alien one,
not recognizing
that which is familiar,
not recognizing a place,
a sound,
feelings.
In hypnosis
you utilize
those past learnings.
R: You now review a number of fairly common everyday experiences to make certain
hypnotic phenomenon seem plausible. The experience of deja vu is a nice analogy that
may evoke associative pathways leading to positive hallucinatory experience. So you
are carefully apposing the possibility of either a negative or positive hallucination in
whatever sense modality it may occur. It is all very open-ended; you will accept and
applaude whatever hypnotic experience she is ready to have.
E: Yes.

Psychological Objectivity from Multiple Points of View


One of the most charming experiences
that children can demonstrate—
and they all do—
they bend over and
look at the world from between their legs,
(Pause.)
because the world is so strange.
Some people remember doing that.
(Pause.)
Most do not remember.
(Pause.)
Memories are so many times
discovered to be false
when they are true memories.
It is due to a change in the person that's not been recognized.
E: This is a terribly important experience. In psychotherapy you have to look at a
problem upside down and sidewise.
R: To break out of your conscious sets.
E: You have to look at your patient as if you were sitting on a seat higher than his. You
also have to look at him from a much lower seat. You need to look at him from the
other side of the room. Because you always get a totally different picture from different
points of view. Only by such a total look at the patient can you gain some objectivity.
R: All these different views add up to a more total objectivity.
E: That's one of the drawbacks of conventional psychoanalysis: you get just one view,
18 inches behind and to the left of the patient. That is a very stereotyped thing.

Plasticity of Perception and Behavior:


Facilitating Change by Breaking Conscious Sets
As examples
I can cite personal incidences.
(Pause.)
When I went back to the farm after being in college,
I found that the stove was unusually small.
(Pause.)
I remembered how I had to stand on my toes
to reach up to the warming oven.
My son Allan returned from Washington, D.C.,
walked through all the rooms of the house,
and remarked,
"I know it is impossible that these rooms have all shrunk.
They are much smaller,
very much smaller."
(Pause.)
(Erickson cites another example wherein one of his daughters as a baby looking up
from her crib learned to associate his head with the ceiling, and the confusion this
association entailed on a later occasion when she saw him closer to his true
proportions.)
E: In hypnotic experiences
you do not try to correct your memories.
You receive them
without automatic correction.
I have watched babies' perception develop.
They start out by seeing one person standing by the crib
until one day,
without verbalizing it,
they now realize there are two.
It takes some length of time to differentiate between mother and father.
It takes still more time to differentiate between big brother or mother and to recognize
three.
E: Pointing out here the child's frame of reference.
R: All of this is to train S to give up her conscious sets, to break down her conscious
frameworks in preparation for change.
E: I want to make her aware that she has many, many rigid sets. Everybody has.
R: So this is a general understanding you try to give every patient in the beginning. You
try to soften up their rigidities by talking of the plasticity of perception and behavior, etc.
E: That's right. You try to make the person aware. There is nothing wrong with having
rigid sets. But if you want to alter yourself in some way, you must be unashamedly
aware that you do have sets and it's better to have a greater variety of sets.
R: So you will have a much wider range in your behavior.
(Erickson here gives several clinical examples of how he gently broke through the
inhibiting conscious sets of patients so they gradually began fuller self-exploration of
their body, etc. (Haley, 1973; Rossi, 1973b).

Not Doing to Facilitate Early Memory and Age Regression


You have those learnings
in adult life, you can correct them,
(Pause.)
but there is no real need to correct them.
They should be appreciated.
A child sees a walking
stick
(Pause.)
As an adult she still shows her wonderment at the walking stick that is actually a
snake.
Psychotherapy using hypnosis,
taking note of past memories
in their purity
without any need to correct them.
As you should want to know what they are.
(Pause.)
We learn to recognize those individual memories
without correcting them.
You then have an opportunity to assess, evaluate
the components of a total understanding.
You meet a person,
and for no reason at all you dislike that person,
but you do have a reason.
You have a walking-stick reason,
you have a head-between-legs-looking-at-the-world reason,
because you have seen something new in that person
in terms
of memories, of learnings.
But as an adult you usually correct these memories,
and you simply say you don't like that person
for no reason at all.
(Pause.)
I'll cite personal incidences,
as I know them better than other instances.
When I walked into the house and my son Lance,
then a small boy
had a problem.
He knew he could not see through a brick wall.
He could see only through windows.
Yet Daddy walked into the house
and said, "You were told not to play with that doily on the table."
He had played with it,
and he happened to be over by a window.
and saw me approaching.
So he carefully replaced the doily except he didn't center it on the table.
That was what he didn't know.
He then attributed my knowledge
that he was playing with the doily
to my being able to see through a brick wall.
(Pause.)
So far as the patient
is concerned
you do not remind yourself of adult understandings.
Nor do you look at behavior with adult understandings.
(Pause.)
R: Here you suggest an hypnotic phenomenon (early memory) by not doing (no need to
correct early memories and childhood distortions) so that it appeals as being effortlessly
easy to one in a placid state of trance. This is actually an indirect approach to age
regression. You don't directly tell her to age regress. By simply mentioning the ways in
which a child sees the world differently, you are hoping to actually evoke her early
modes of perception and thereby facilitate the possibility of a genuine age regression.
E: That's right.

Questions as Indirect Suggestions:


Displacing Doubt and Discharging Resistance
How soon
do you think
you will be willing
to open your eyes
and not see your hands?
E: What does this question really do? Put it into separate sentences:
1. You will open your eyes.
2. You will see.
3. You will not see certain things. Those are actually commands.
R: But they are stated in a question as a fait accompli.
E: Yes. It's stated as a question, but the only real question it asks is, "At what time will
it be done?" You are displacing all doubt onto the question of the time. That is the only
thing that needs to be doubted. All the rest is actuality.
R: You've done that with a question I would call an implied directive.
E: Yes. The common mistake in psychotherapy is to give a patient directions without
recognizing there have to be doubts.
R: In our society we invariably doubt and test any suggestion that is made to us. This
may be the social basis of the so-called resistance. Perhaps that is why the Freudians
talk so much about resistances. The typical therapist does not know how to present
directives in a way that would discharge resistances automatically as you have here
illustrated. You are always discharging resistances and doubts by the way you express
things.

Validating Suggestions for Negative Hallucination


You have not seen your hands many times in the past
when they were in direct line of vision.
(Pause.)
An adult can learn to see things
in direct line of vision.
And you also learned
not to see your hands
when they were in a direct line of vision.
(Pause.)
E: Now I tied that question to an actual thing: "You have not seen your hands many
times in the past."
R: You validate the suggestion by juxtaposing it with a common perceptual experience
of the past.
E: How many times have we not seen "the impossible not to see?"
R: As I'm looking at this microphone I'm holding in front of you right now I realize that I
was not seeing my hand that's holding it.
E: That's right! A magician makes his living out of that. He utilizes your ability not to see
what he is doing.

Conscious and Unconscious, Communication by Logic and Experience


[Here Erickson gives another fairly complex example of how adult and child memories
of the same phenomenon can be different because of their different points of view.
Because of this we find that there are frequently two sets of memories, which
sometimes gives rise to confusion in patients.]
E: In psychotherapy you learn to recognize how things can be different things.
(Pause.)
I am going to suggest that you open your eyes and keep them open, and be aware
not to see.
(Pause.)
[S opens her eyes and reorients to her body.]
R: So it is a good approach to tie your suggestions to an undeniable experience they
have had. That tends to validate your suggestions. What are you trying to convince
with these validating analogies from everyday life? The conscious or the unconscious?
E: The unconscious knows all about these things!
R: You're telling the unconscious what mental mechanisms to use by analogy.
E: Yes.
R: At the same time the logic of the analogy impresses the conscious mind. Would you
say that?
E: The logic appeals to the conscious mind, and the unconscious has the conviction of
actual knowledge (experiential knowing).
R: So you're speaking to both the logic of the conscious mind and the experience of the
unconscious.
E: The conscious mind understands the logic of it, and the unconscious understands
the reality.
R: What do you mean by reality here?
E: You just demonstrated it by seeing the microphone but not your hand.
R: The unconscious knows reality from concrete experiences. E: Yes.
R: When S opened her eyes and came out of trance, she rubbed her hands together as
one of her typical acts of reorientation to her body, but she did not comment on
whether or not she was actually seeing them. By implication we can assume that she
was not seeing her hands since she was so absorbed in recounting her early
memories. You did not tell her to awaken, but in her case the association between
opening eyes and ending trance was stronger than your implication that she could
open her eyes and remain in trance and not see.

Subjective Experience of Trance:


Genuine Age Regression, Hypermenesia, and Amnesia
S: I had an experience
where I was actually a year old and looking up from a crib. There was an experience
from three years old when I was drinking from cups and getting splashed on my left
hand.
I was thinking about the feeling that I had. It's like the song about Alice, "She was ten
feet tall,"
and I had the fear of getting a glass of water and having to bend over her because I
was so tall.
E: And even that
you could do without terrifying emotions.
S: Yes, it was like untrue,
like I had been eating some magic mushrooms.
I guess you look at things different. That flashed through my mind when I tried to walk
on stilts as a child.
It took all afternoon, and they finally did work.
E: And you saw things
very high?
S: They were! Those stilts were over my head.
[This session terminates with a recounting of the many memories that returned to S
during her trance experience.]
Dr. S later wrote the following about her inner experience at this point.
"As I later read my remarks, I was confused because I could recall only the first part
where I described myself as being in a crib. I remember that experience as though I
actually were small and looking up at a big world (genuine age regression). I have
amnesia now for the three-year-old incident, and the last one is not as I recall it. My
recollection here is that I was thirsty after the trance work and wanted to go into the
next room for a drink of water. However, I could not seem to mobilize myself. I could
not pick up the glass of water by my chair. I was somehow still Alice in Wonderland, ten
feet tall, so I was afraid that I would have to bend to get through the doorway and that
might make me dizzy.
"My explanation is that I must have gone into a trance again as I began to describe the
trance events. I recall that I was wearing a dress with long butterfly sleeves. My wrists
were bent over the end of the arm of the chair and covered by my sleeves. This is in
contrast to my usual habit of keeping them in my lap. Apparently since I had the
impression that I could not pick up a glass, I had (in a complex fashion) followed the
suggestion (unrecalled by me) of not seeing my hands.
"There is an unconscious!"
R: This was a fantastically successful trance experience for S. She managed to give up
some of the limiting sets of her conscious mind, so she had an apparently genuine
experience of age regression wherein she experienced herself in a crib and actually
saw the world the way a child would. She experienced hypermenesia (the extensive
recall of early memories) and, paradoxically, she also experienced an amnesia (she
forgot some trance events). She acknowledges how she managed not to see her
hands to comply in her own individual fashion with your suggestion and how this
immobilized her so she could not even pick up a glass of water. You attempted to
evoke a negative visual hallucination for her hands "when they were in direct line of
vision." But apparently her unconscious could only manage not seeing her hands by
immobilizing them out of her view at this time. It's really charming to witness her
individuality: to immobilize is easier for her at this point than not seeing. And, most
significantly for future hypnotic work, she really acknowledges the reality of the
unconscious!

DISPLACING AND DISCHARGING RESISTANCE


In practical clinical work we find that "resistance" frequently means that the patient is
stuck with a few patterns of association and experience that are interfering with opportunities
for new learning. We thus tend to view resistance as an erroneous mental set that gets in the
way of new experience. Resistance need not always be understood in the psychoanalytic
sense as something that is continually maintained by deep and unconscious forces. Rather,
resistance can be a relatively simple wrongheaded attitude that prevents people from utilizing
their own abilities.
Erickson has developed a number of approaches for displacing and discharging
resistance that seem merely humorous, clever, and superficial. These approaches can help
patients dodge free of their own "mental blocks" in relatively short order, however.
In a typical case an aggressive patient may enter the situation blustering, "I need
hypnotherapy and I'm sure I can't be hypnotized." On one such occasion Erickson happened
to have three other empty chairs in the office and proceeded as follows:
E: There is, of course, a possibility that you can be hypnotized. (Pause.)
Erickson opens the door by mentioning the "possibility" of trance.
There is more possibility that you can't be hypnotized.
He then reinforces or gains acceptance of that "positive possibility" by his open
acknowledgment and acceptance of the patient's negative attitude. The patient
immediately feels respected, and a positive rapport is established.
Now let's try this chair.
Implying that the question of going into trance has something to do with which chair is
being used. This begins the process of displacing the resistance from the patient to the
chair.
If you fail in this one, there is still the possibility that you can go into trance.
This gives the patient an opportunity to fail and thus prove his point that he "can't be
hypnotized." This initial failure allows the patient to "use up" and discharge his
resistance.
[The patient failed to enter trance in three of the chairs. He finally experiences a
satisfactory trance in the fourth chair. Each time he failed he "used up" another
increment of resistance until trance became inevitable because of the way the above
implication displaced the resistance from the patient to the details of seating
arrangements, etc.]
Erickson will typically vary the procedure slightly with each effort (e.g., shifting direction
of the chairs, shifting his chair, altering the induction procedure to find the one most
satisfactory to the patient.
Another means of displacing and discharging resistance is through games and
seemingly irrelevant but humorous challenges whereby the therapist actively evokes and
then discharges the resistance by way of a predictable denouement.
As an example, say that you have a bunch of marbles only one of which is a solid color.
You tell a child that you are going to write down on paper which marble he is going to
choose. You take the position that you are going to predict and force the child to accept your
choice. The child accepts the challenge and maintains that you cannot predict his choice.
You then begin describing the various marbles as his possibilities: the blue one with white
stripes, the brown and white, and so on. He hears you describing all the marbles in a
seemingly random manner. He does not notice that you always pick a color combination. He
can escape by picking a marble with no color combination—the solid color marble that you
previously wrote down as his eventual choice.
In this case you create the resistance by saying, "I can predict your choice." You insisted
that he was going to choose one of the color combinations you mentioned, but he puts an
end to your speculations by choosing the solid color you had previously predicted when you
wrote it down. The child does not know how you did it, yet there was a genuine rationale for
predicting his choice. The child is now intrigued and open to other things you have to say to
him.
The same procedure can work with a resistant adult. You look at the bookcase in your
office and say that you can predict which book the patient will choose. You then mention all
the various possibilities of choice: the dark books with light printing and those that are the
reverse, the multicolored bindings, the odd-sized books, and others. You carefully avoid
mentioning just one book. Patients invariably resist all the possibilities you mention and pick
the one you did not. Patients experience a surprise upon finding out that you had written
down their choice before the game started. Their resistance tends to remain in the bookcase,
and they are now simply open and curious about what you are up to. When the whole
procedure is carried out in a low key, fun manner rapport is enhanced. Any serious
challenge, of course, is to be avoided with an adult. Should the therapist fail to predict the
book that the patient chooses, all is not lost. The patient is now "one up" and feels more
relaxed; he now owes it to the therapist to be obliging by entering trance, etc. Resistance has
been discharged in the play, and the patient is now available for therapeutic work.
Erickson's efforts to displace doubt and discharge resistance are a unique contribution to
psychotherapy. It is clear that this approach can be useful in any form of therapy where
careful consideration is taken to help the patient circumvent his own learned limitations in
order to achieve something new.
Erickson provided another example of a very common situation in therapy where he
regularly displaces doubt and discharges resistance as follows:
E: A woman patient came to me with a great many doubts about how much she could tell
me. So I said, "All right, hold back everything that you could possibly have some doubt about
telling me."
R: So that immediately mobilized in her mind all the possible things she could say.
E: Yes, by the end of the hour she told me everything because once she told me one thing it
led to the next. She finally found she had nothing she had any doubts about telling me. An
analyst could have dealt with those resistances for several years.
R: Whenever you give important directives, you try to provide a lightning rod to discharge
their resistances.
E: Without bringing an awareness of that resistance into the foreground. You don't want your
patient to think about resistances.
R: You discharge resistances without their even being aware that it is happening.
E: To discredit this as manipulation is as faulty as it is to describe food as being manipulated
because you have seasoned it properly.
Further insight into Erickson's approach to discharging negativity and resistance is in the
way he gets a patient's "no" away from the therapy situation and gradually replaces it with
"yes." With a resistant patient ("resistant" here means there is a lack of understanding; one
usually resists when, because of a lack of understanding, one anticipates harm) he
sometimes begins by saying, "You don't like all that smog out there do you?" Of course the
patient answers with "no." Erickson then continues with a series of questions that elicit a "no"
response about things far removed from the therapy situation. This process gives patients an
opportunity to displace and discharge their resistance away from the therapy situation.
Erickson then proceeds to ask questions that will elicit a "yes" about the therapy situation
(e.g., Are you as comfortable in that chair as you can be?")
The "yes" responses then generalize to a greater extent than the patient realizes. One
question about comfort, for example, does not convince patients that the therapist is
concerned about their comfort and welfare. But a series of questions about comfort begins to
generalize through the patient's associative process. The possibility of comfort, for example,
now becomes associated with the difficult or traumatic material the patient is struggling to
express.
It is apparent that Erickson is using a process orientation to shift resistance and "no" out
of the therapy situation and to bring comfort and "yes" into the therapy situation. That is, the
actual content of the "no" or "yes" is irrelevant. Any expressed "no" will help discharge
negativity regardless of its particular content. Any expressed "yes" will generalize further
cooperation regardless of the subject matter.
On careful reflection it will be found that this orientation to process is more frequently
prominent in Erickson's approach than his concern about content. In inducing trance, for
example, he utilizes the process of confusion to depotentiate consciousness; the actual
subject matter or content of the confusion is irrelevant. In training a hypnotic subject it is the
process of experiencing one and then a series of hypnotic phenomena that is important, not
the content of the particular phenomena. In facilitating therapy it is the process of getting any
noticeable improvement that is important, even if it is initially far removed from the content of
the patient's most pressing problem. Content, to be sure, is important, but its importance is
usually as a vehicle to gain entry to the patient's attention and associative structures where
the process of therapy can be facilitated.

Exercises in Displacing Doubt and Resistance


1. Discharging resistance in everyday life. Think of occasions in which you were firmly
against something and to your surprise found yourself going along with it nonetheless. You
may later criticize yourself for "compromising," "giving in," or having "weak willpower." But
actually you were probably caught in a situation where your resistance was intentionally or
accidentally discharged by another person or circumstances. Can you recall your feelings at
the moment when you "gave in?" Can you trace out the psychodynamics of how your
resistance was discharged? Can you formulate how you could utilize this example of
discharging resistance in a psychotherapeutic situation?
2. Keep a record of all your examples of displacing doubt and discharging resistance in
everyday life and psychotherapy. When you have enough examples, try to formulate some
general hypotheses about the psychodynamics of displacing doubt and discharging
resistance. Can you now design psychological experiments that could test the validity of your
hypotheses? Publish your results!

MULTIPLE LEVELS OF COMMUNICATION: ANALOGY,


PUNS, METAPHOR, JOKES, AND FOLK LANGUAGE
Erickson's penchant for communication by analogy is herein explained as communication
on two levels: the conscious and the unconscious. The logic of an analogy can appeal to the
conscious mind and break through some of its limiting sets. When the analogy also refers to
deeply engrained (automatic and therefore functionally unconscious) associations, mental
mechanisms, and learned patterns of behavior, it tends to activate these internal responses
and make them available for problem solving. Suggestions made by analogy are thus a
powerful and indirect twofold approach that mediates between the conscious and
unconscious. Appropriate analogies appeal to the conscious mind because of their inherent
interest while mobilizing the resources of the unconscious by many processes of association.
The authors (Erickson and Rossi, 1976) have discussed multilevel communication in
terms of Jenkins' contextual theory of verbal associations (1974). Analogy, puns, metaphor,
paradox, and folk language can all be understood as presenting a general context on the
surface level that is first assimilated by consciousness. The individual words and phrases
used to articulate that general context, however, all have their own individual and literal
associations that do not belong to the context. These individual and literal associations are,
of course, usually suppressed and excluded from consciousness in its effort to grasp the
general context. These suppressed associations do remain in the unconscious, however, and
under the special circumstances of trance, where dissociation and literalness are heightened,
they can play a significant role in facilitating responsive behavior that is surprising to
consciousness.
This situation can be made clear by analogy. The adult reader is usually searching for an
author's meaning. Within certain limits it really doesn't matter what particular sentences or
words are used. Many different sentences and combinations of words could be used to
express the same meaning. It is the meaning or the general context of the sentences that
registered in consciousness, while the particular sentences and words used fall into the
unconscious and are "forgotten." In the same way one "reads" the meaning of a whole word
rather than the individual letters used to make up the word. The general context of the letters
registers as the conscious meaning of a word rather than the individual associations of each
letter. Jenkins (1974) has summarized the data of recent experimental work in the area of
verbal association, event recognition, information integration, and memory that places a
similar emphasis on the significance of context to understand these phenomena. In any
discourse or phenomena using words it is usually the general context that establishes
meaning rather than the structural units that create the discourse.
The obvious exceptions to this, of course, are in puns, allusions, and all sorts of verbal
jokes where the punch line depends on literal or individual verbal associations to words and
phrases that originally escaped the attention of consciousness. Verbal jokes depend on literal
or individual associations that are usually suppressed.
In the same way Erickson's two-level communication utilizes a general context to fixate
the attention of consciousness while the individual associations of words, phrases, or
sentences within that context are registered in the unconscious, where they can work their
effects. From this point of view Erickson's Interspersal Technique (1966) is the clearest
example of two-level communication wherein subject matter of interest to a particular patient
is utilized as a general context to fixate conscious attention while interspersed suggestions
are received for their effects on an unconscious level.
Erickson has devised a number of other techniques to activate the individual, literal, and
unconscious associations to words, phrases, or sentences buried within a more general
context. Turns of phrase that are shocking, surprising, mystifying, non sequiturs, too difficult
or incomprehensible for the general conscious context, for example, all tend momentarily to
depotentiate the patient's conscious sets and to activate a search on the unconscious level
that will turn up the literal and individual associations that were previously suppressed. When
Erickson overloads the general context with many words, phrases, or sentences that have
common individual associations, those associations (the interspersed suggestion) gain
ascendancy in the unconscious until they finally spill over into responsive behavior that the
conscious mind now registers with a sense of surprise. The conscious mind is surprised
because it is presented with a response within itself that it cannot account for. The response
is then described as having occurred "all by itself without the intervention of the subject's
conscious intention; the response appears to be autonomous or "hypnotic."
Analogy and metaphor as well as jokes can be understood as exerting their powerful
effects through the same mechanism of activating unconscious association patterns and
response tendencies that suddenly sum-mate to present consciousness with an apparently
"new" datum or behavioral response.

THE MICRODYNAMICS OF SUGGESTION


Once Erickson has fixated and focused a patient's attention with a question or general
context of interest (e.g., ideally, the possibility of dealing with the patient's problem), he then
introduces a number of approaches designed to depotentiate conscious sets. By this we do not
mean there is a loss of awareness in the sense of going to sleep; we are not confusing trance
with the condition of sleep. In trance there is a reduction of the patient's foci of attention to a few
inner realities; consciousness has been fixated and focused to a relatively narrow frame of
attention rather than being diffused over a broad area, as in the more typical general reality
orientation (Shor, 1959) of our usual everyday awareness. When fixated and focused in such a
narrow frame, consciousness is in a state of unstable equilibrium; it can be "depotentiated" by
being shifted, transformed, or bypassed with relative ease.
Erickson believes that the purpose of clinical induction is to focus attention inward and to
alter some of the individual's habitual patterns of functioning. Because of the limitations of
patients' habitual frames of reference, their usual everyday consciousness cannot cope with
certain inner and/or outer realities, and they recognize that they have a "problem."
Depotentiating patients' usual everyday consciousness is thus a way of depotentiating facets
of their personal limitations; it is a way of deautomatizing (Deikman, 1972) an individual's
habitual modes of functioning so that dissociation and many of its attendant classical
hypnotic phenomena (e.g., age regression, amnesia, sensory-perceptual distortions,
catalepsies, etc.) are frequently manifest in an entirely spontaneous manner (Erickson and
Rossi, 1975). Depotentiating the limitations of the individual's usual patterns of awareness
thus opens up the possibility that new combinations of associations and mental skills may be
evolved for creative problem solving within that individual.
Erickson's approaches to depotentiating conscious sets are so subtle and pervasive in
the manner with which they are interwoven with the actual process of induction and
suggestion that they are usually unrecognized even when one studies a written transcript of
his words. In order to place them in perspective we have outlined the microdynamics of
induction and suggestion in Table 1 as: (1) the Fixation of Attention; (2) Depotentiating
Conscious Sets; (3) Unconscious search; (4) Unconscious Processes; and (5) Hypnotic
Response. We have also listed a number of Erickson's approaches to facilitating each stage.
Most of these approaches are illustrated in this volume and are discussed in more detail
elsewhere (Erickson and Rossi, 1974; Erickson and Rossi, 1975; Haley, 1967; Rossi, 1973).
Although we may outline these processes as stages of a sequence in Table 1 for the purpose
of analysis, they usually function as one simultaneous process. Because of this, and in order
to distinguish these processes from the broader dynamics of induction and mediating
variables previously outlined (Barber and DeMoor, 1972) we designate ours as
"microdynamics." When we succeed in fixating attention, we automatically narrow the focus
of attention to the point where one's usual frames of reference are vulnerable to being
depotentiated. At such moments there is an automatic search on the unconscious level for
new associations that can restructure a more stable frame of reference through the
summation of unconscious processes. There is thus a certain arbitrariness to the order and
the headings under which we assign some of the approaches Erickson used in Table 1. He
could equally well begin with an interesting story or pun as with a shock, surprise, or a formal
induction of trance. Once the conditions in the first three columns have been set in motion by
the therapist, however, the patient's own individual unconscious dynamics automatically
carries out the processes of the last two columns.
Table 1
The Microdynamics of Trance Induction and Suggestion
(1) (2) (3) (4) (5)
Fixation of attention Depotentiating Conscious Sets Unconscious Search Unconscious Process Hypnotic Response
1. Stories that motivate, 1. Shock, surprise, the 1. Allusions, puns, jokes 1. Summation of: "New datum of behavioral
interest, fascination, etc. unrealistic and unusual 2. Metaphor, analogy, folk a) Interspersed response experienced as
2. Standard eye fixation 2. Shifting frames of language suggestions hypnotic or happening all by
3. Pantomime approaches reference; displacing 3. Implication b) Literal associations itself"
4. Imagination and doubt, resistance and 4. Implied directive c) Individual associations
visualization approaches failure 5. Ideomotor signaling d) Multiple meaning of
5. Hand levitation 3. Distraction 6. Words initiating exploratory words
6. Relaxation and all forms of 4. Dissociation and sets 2. Autonomous, sensory and
inner sensory, perceptual or disequilibrium 7. Questions and tasks perceptual processes
emotional experience 5. Cognitive overloading requiring unconscious 3. Freudian primary
etc. 6. Confusion, non sequiturs search processes
7. Paradox 8. Pause with therapist 4. Personality mechanisms of
8. Binds and double binds attitude of expectancy defense
9. Conditioning via voice 9. Open-ended suggestions 5. Ziegarnik effect
dynamics, etc. 10.Covering all possibilities of etc.
10.Structured amnesia response
11.Not doing, not knowing 11.Compound statements
12.Losing abilities, the 12.Intercontextual cues and
negative, doubt suggestions
etc. etc.

A number of Erickson's most interesting approaches to facilitate hypnotic response are


the hypnotic forms listed in column 3 of table 1. All these approaches are designed to evoke
a search on the unconscious level. Allusions, puns, metaphors, implications, and so on are
usually not grasped immediately by consciousness. There is a momentary delay before one
"gets" a joke, and in part, that is what is funny about it. In that delay period there obviously is
a search and processes on an unconscious level (column 4) that finally summate to present
a new datum to consciousness so that it gets the joke. All the approaches listed in column 3
are communication devices that initiate a search for new combinations of associations and
mental processes that can present consciousness with useful results in everyday life as well
as in hypnosis. The hypnotic forms listed in columns 2 and 3 are also the essence of
Erickson's indirect approach to suggestion. The study of these approaches may be regarded
as a contribution to the science of pragmatics: the relation between signs and the users of
signs (Watzlawick, Beavin, and Jackson, 1967). Erickson relies upon the skillful utilization of
such forms of communication, rather than hypersuggestibility per se, to evoke hypnotic
behavior.
As noted in Chapter One, it is important to recognize that while Erickson thinks of
therapeutic trance as a special state (of reduced foci of attention), he does not believe
hypersuggestibility is a necessary characteristic of such trance (Erickson, 1932). That is, just
because patients are experiencing trance, it does not mean they are going to accept and act
upon the therapist's direct suggestions. This is a major misconception that accounts for many
of the failures of hypnotherapy; it has frustrated and discouraged many clinical workers in the
past and may have impeded the scientific exploration of hypnosis in the laboratory.
Therapeutic trance is a special state that intensifies the patient-therapist relationship and
focuses the patient's attention on a few inner realities; trance does not ensure the
acceptance of suggestions. Erickson depends upon certain communication devices such as
those listed in column 3 to evoke, mobilize, and move a patient's associative processes and
mental skills in certain directions to sometimes achieve certain therapeutic goals. He believes
that hypnotic suggestion is actually this process of evoking and utilizing a patient's own
mental processes in ways that are outside his usual range of ego control. This utilization
theory of hypnotic suggestion can be validated if it is found that other therapists and
researchers can also effect more reliable results by carefully utilizing whatever associations
and mental skills a particular patient already has that can be mobilized, extended, displaced,
or transformed to achieve specific "hypnotic" phenomena and therapeutic goals.
In the therapeutic trance situation the successful utilization of unconscious processes
leads to an autonomous response; patients are surprised to find themselves confronted with
a new datum or behavior (column 5). The same situation is in evidence in everyday life,
however, whenever attention is fixated with a question or an experience of the amazing, the
unusual, or anything that holds a person's interest. At such moments people experience the
common everyday trance; they tend to gaze off (to the right or left, depending upon which
cerebral hemisphere is most dominant, (Baken, 1969; Hilgard and Hilgard, 1975) and get that
"faraway" or "blank" look; their eyes may actually close, their body tends to become immobile
( a form of catalepsy), certain reflexes (e.g., swallowing, respiration) may be suppressed, and
they seem momentarily oblivious to their surroundings until they have completed their inner
search on the unconscious level for the new idea, response, or frames of reference that will
restabilize their general reality orientation. We hypothesize that in everyday life
consciousness is in a continual state of flux between the general reality orientation and the
momentary microdynamics of trance as outlined in Table 1. The well-trained hypnotherapist
is acutely aware of these dynamics and their behavioral manifestations. Trance experience
and hypnotherapy are simply the extension and utilization of these normal psychodynamic
processes. Altered states of consciousness—wherein attention is fixated and the resulting
narrow frame of reference is shattered, shifted, and/or transformed with the help of drugs,
sensory deprivation, meditation, biofeed-back, or whatever—follow essentially the same
pattern but with varying emphasis on the different stages. We may thus understand Table 1
as a general paradigm for understanding the genesis and microdynamics of altered states
and their effects upon behavior.

Exercises with Analogies Puns, and Metaphors


1. Create analogies and metaphors that are interesting and arresting to the conscious
mind while also activating habitual modes of unconscious functioning that can be used to
facilitate all the standard hypnotic phenomena.
2. When planning a therapeutic approach to a particular patient's problem, utilize puns,
analogies, metaphors, and folk language that will have the following:
a. A direct appeal for that individual in terms of his lifetime interests.
b. Directly activate by association habitual modes of functioning in the patient that can
facilitate a therapeutic goal.
Note that such analogies can be effective with or without trance. In trance, however,
analogies can be considered as specific tools for facilitating desired responses.
SEVEN

Indirectly Conditioned Eye Closure Induction


Erickson continues in this session to deal with Dr. S's major problem in learning to
experience trance: allowing and trusting unconscious modes of functioning. This is the most
typical problem the modern hypnotherapist must learn to cope with in our western culture
where the rational aspect of mind is valued above all others. It is the bias and hubris of the
rational and intellectualized mind to downgrade the accomplishments and possibilities of the
unconscious. The conscious mind likes to believe in its autonomy and power. In actuality,
consciousness is always focal and thus limited to what is within its momentary focus. It
cannot possibly deal with everything all at once; at every moment in our lives we are
dependent on unconscious processes (to regulate everything from our blood chemistry to our
next verbal association). Consciousness is a relatively recent evolutionary acquisition.
Although we like to believe that consciousness is a high form of evolutionary development, it
is in fact extremely labile and limited in its abilities.
A major problem of consciousness as it is presently constructed is that it frequently
excludes everything outside of its immediate focus and it tends to believe only in its own
momentary mood and truth. No wonder there are so many lethal conflicts within us as
individuals and between us as people. Because of these limitations it is important that
consciousness be expanded (awareness heightened) by learning to relate optimally to the
unconscious. For Erickson this would mean allowing the unconscious an opportunity to do its
own work. Therapeutic trance can be understood as a state in which unconscious work is to
some extent freed from the limiting foci and sets of consciousness. Once the unconscious
has done its work, the conscious mind can receive and focus it appropriately in the various
moments and sets (circumstances) of life. The unconscious is a manufacturer and
consciousness is a consumer; trance is a mediator between them.
Erickson begins the session with remarks that tend to confuse and depotentiate
consciousness. He then demonstrates another indirect approach to induction by conditioning
eye closure. He emphasizes the need for careful observation of trance induction by a scaling
procedure. Of particular value in the commentaries of this session are examples of
Erickson's unusual perceptiveness in dealing with a number of difficult issues in trance work,
including sources of psychological confusion, "lies" in trance, alternating rhythms of
suggestibility in trance, posthypnotic suggestion, dealing with spontaneous awakening, and
ways of protecting the subject in trance.

Confusion in Trance Induction


Erickson begins the session by asking S what she would like to accomplish today. S
mentions a wart she would like to have go away but does not volunteer any personal
problems she might want to deal with. A desultory conversation takes place for a few
minutes. Then Erickson quietly remarks, "Probably Dr. Rossi is noticing something."
This was a hint to R to notice that S's eye blink reflex was spontaneously beginning to
slow down. R isn't sure just what is happening, but he is aware Erickson is telling him
to observe S carefully. S laughs self-consciously and asks what is going on. Erickson
assures her that she will know soon enough. After a moment's pause Erickson
continues.
E: How soon do you think you will know?
S: I don't even know what I'm supposed to know. What I'm ready for?
(Pause)
What am I supposed to know?
(Pause.)
R: You frequently use this approach of hinting that something is happening that the
patient's consciousness is not tuned into. It tends to confuse the patient, it
depotentiates the ego's subjective sense of control, and it builds up a high expectancy
that something unusual and significant will happen. Her questions clearly indicate the
great confusion that has been induced by your simple remark, "Probably Dr. Rossi is
noticing something."

Indirectly Conditioned Eye Closure Induction


E: Now I'll say odd and even for a specific purpose.
S: Will you tell me?
E: At the end.
Even.
Odd.
(Pause.)
Odd.
Odd.
Odd
Even.
(Pause.)
[S is obviously puzzled by Erickson's odd-even statements. He is talking in a way that
is apparently meaningful, yet she cannot grasp his meaning. After a moment of
concentrated attention she apparently gives up and lapses into herself]
E: You say "odd" when the eye blink is slow and "even" when it is fast.
R: You just say that without her being aware of what you were doing?
E: Yes.
R: What does that do to her?
E: She makes the connection unconsciously. She begins with two blinks, one fast and
one slow. Unconsciously she noticed that I said "odd" after the slow blink. So then she
pauses and then blinks slow three times. She gives a more rapid blink and pauses
again.
R: This is an induction procedure or what?
E: It is an induction procedure because you're closing the eyelids. It is a technique to
close the eyelids.
R: Why will the eyelids close? E: Because it becomes a conditioned response. "Odd"
becomes associated with a sensation of slowness if you say it each time there is a slow
blink.
R: Once you've established that association, you need only say "odd" and the eyelids
will get slower and slower and finally close. Is this another subtle or indirect way of
inducing trance? Is it an unconsciously conditioned response for induction?
E: Yes. It's an unconsciously conditioned response.

Observation Scale for Hypnotic Depth


She is going back and forth on a scale of 1 to 100.
S: I usually don't blink so much.
E: Now she is up to about 15.
(Pause.)
50
35, 40
15, close
[To R: Now I let that be prolonged. I interrupted it so it could be demonstrated
thoroughly. Ordinarily you wouldn't make prolonged use of this. This is a chance for
you to see it in operation.]
E: On a scale of 1 to 100 where a 100 is deep trance. When the eyes close when you
say "close," the subject is perhaps at 10.
R: You are using your own subjective scale when you say she is up to 15, 50, etc.
When she was up to 15, I noticed her face beginning to iron out. At 40 I noticed more
quietness.
E: I said "close" here when the eyes were closing on a slow blink, and that served to
close them.

Trance as Experiential Rather Than Intellectual Learning


Now I know that S wants to drift.
(Pause.)
Now there you saw the conscious mind recognizing a word of significance. After a
while she will let the drifting remain unconscious.
(Pause.)
[To S] Now searching through things you really want
for many different reasons,
not only for an understanding of them
but for an experience of them.
(Pause.)
R: At the word "drift" there was a visible relaxing of S that was apparently mediated by
ego consciousness, since it was obvious and quick. When relaxation is mediated by
the unconscious, it is somehow more subtle. Her conscious mind recognized the work
"drift" as her own description of deepening trance (see end of first session).
E: Now S has been trying to get some rational understanding of hypnosis. She doesn't
realize that to learn to swim you have to get in the water to actually experience it.
Intellectual book knowledge about swimming won't do it. She has been trying to get in
the trance and understand. But she should just get in the water first.
R: When the patient tries to observe and understand, it interferes with the process of
learning by the experience of just letting things happen. In trance it is necessary to
learn by experiencing rather than intellectualizing.

Interspersed Suggestions:
Multilevel Statement to Conscious and Unconscious
As you know enough
about phenomena
so you can let your own unconscious mind
elaborate
whatever phenomena you wish.
And in any direction.
And you should do that as an experience for yourself as a discovery of what your
unconscious mind can do.
E: "Elaborate" is separated off as a separate word to make it a command.
R: What's the command?
E: "So you can let your own unconscious mind" is a permissive statement that the
conscious mind hears. "Elaborate" makes it a command which the unconscious hears.
It's an interspersal technique. It's not noticeable that a command has been given.
R: What's the interspersed message here?
E: The word "elaborate." The emphasis on this word changes it from just another word
in the sentence to a specific word.
R: A specific direction and command to the unconscious is given with the emphasis on
that word "elaborate."

Covering All Possibilities of Response to Facilitate Suggestion


Your unconscious mind can decide what part
or what aspects
of the experience should be shared by Dr. R and me.
By others in general.
By patients with whom you work.
(Pause.)
With others within you.
Also, your understandings belong to you.
But it is possible
for you to share with others in ways you never thought of before.
E: She thinks, "Should I share this with Dr. R, knowing that I know Dr. R only to such
and such a degree? Is this something he can tolerate? Is this something he can be
interested in?"
R: These statements are a series of psychological truisms wherein you mention
all possibilities of response and thereby bring whatever she does into association with
you and your words. It is easy for her to accept and follow any one of these truisms, but
whatever she chooses will actually place her in the situation of following your words
and thus reinforce her rapport with you and her tendency to follow other suggestions.

Depotentiating Consciousness with Boredom:


An Example of Indirect Suggestion
I'll give you a personal example.
In learning the multiplication tables at school my teacher said, "I do not know what
you are doing, but you have all the answers right." I had to wait until I got to college to
explain to my teacher what it was I had done.
(Pause)
I have a son whose teacher said, "Now I don't know what you are doing in your
arithmetic lessons, but you do have the right answers, so keep right on with whatever
you are doing."
The reason he didn't know
was that my sixth grade son was using logarithms.
This baffled the teacher.
This bewildered my son,
and he reached the conclusion that a slide rule was a child's plaything.
I sent him to a library to find some books there that might interest him.
He found a book of logarithms
and began a formal study of logarithms
and tried to teach them to his teacher.
But he really couldn't explain logarithms to his teacher,
and he later found that to teach logarithms to college students is quite a job.
I told him how I did my math.
He said,
"Well I tried that long ago, but it's too simple."
When you use multiplication tables, there is a mathematical relationship among the
answers. If you know the mathematical relationship among the answers. If you know
the mathematical relationship, you know all the answers.
Take the 7 times table:
7x1=7
7 x 2 = 14
7 x 3 = 21
7 x 4 = 28
7 x 5 = 35
7 x 6 = 42
7 x 7 = 49
7 x 8 = 56
7 x 9 = 63
If you know this relationship of progression in the last digit, it is easy to remember the
whole table.
R: S is in a light trance at this point, so what is the purpose of giving such a complex
and detailed mathematical example in such a disjointed manner? Won't this activate
her conscious mind and defeat the process of deepening the trance and unconscious
learning?
E: Often with highly sophisticated subjects you resort to uninteresting detail to bore the
hell out of them.
R: That's what you're doing here? You're boring the hell out of her? That's why you
used this mathematical example! Well, you were succeeding because at that point I
was also going into a trance myself.
E: They don't know what you are doing. They try to be polite, and this, past experience
has taught them, can be awfully fatiguing.
R: So this is a way of making her tired.
E: Yes. Without telling her to be tired!
R: I see. You're taking all the spunk and fire and energy out of her intellect. You're
discharging it with this boredom. You're fizzling it out with boredom.
E: That's right.
R: I see! I was bored too! I was wondering, "Is this supposed to be brilliant
hypnotherapy? What is this?" But now that I can see what it was used for, I can realize
it's marvelous. You were depotentiating consciousness by boring it out of existence.
E: Yes. That's right.
R: This is an excellent example of your indirect approach to suggestion. You did not
directly suggest she would be relaxed or tired. Rather, you had recourse to evoking a
certain psychological situation or stimulus (boring arithmetic) that will arouse an internal
response (acting polite) that will in turn evoke an experience of mental fatigue by
associations and processes that already exist within her. She is not able to recognize
the relation between what you are saying and what she is actually experiencing.
Because of this the indirect suggestion escapes her conscious attention. She is
responding in a certain way but may not know exactly why. This not knowing is
compatible with the essence of trance, which is to allow more autonomous or
spontaneous responses take place without the habitual sets of consciousness
structuring, directing, and controlling them.
For the benefit of the reader I'll point out that I think the relationship you mean is that
the last digits in the 7 times table actually form a progression that is easy to see when
they are arranged in rows of three:
7 8 9
4 5 6
1 2 3
Of course, it would be hopeless for someone trying to go into trance to figure that out,
so their consciousness just gives up. And that is trance when the normal ego
consciousness is no longer directing and controlling things as usual.

Personal Meanings:
Discharging Negative Attitudes
Now personal meanings
to you
are yours.
The application
of all those meanings
to others
is an entirely different thing.
I could know
mathematical relationships
and couldn't explain them
to my teacher.
My son could not explain to his teacher.
But we get the same answers as they get.
We could not explain why we preferred our way.
(Pause.)
E: I'm trying to get her to understand: what may be pleasant and agreeable to one may
not be pleasant and agreeable to others.
R: Why do you put that in here?
E: How many times has a patient said to you, "But you wouldn't be interested in
hearing this." That's a very inhibiting thing in them. They are inhibiting themselves.
You've got the task of telling them, "You are interesting."
R: You're breaking through a negative attitude of consciousness. Again you're telling S
that she does not have to understand trance intellectually, she just needs to experience
it.

Source of Psychological Confusion


Now the matter of hallucination,
of regression,
of time distortion,
the selection of memories,
the achieving of understandings,
the isolation of the self from a situation.
(Pause.)
I exist in the office.
(Pause.)
E: She might be intellectually interested in any of these phenomena, but she doesn't
know if her unconscious wants them.
R: We have to be humble enough to let our unconscious direct and experience
whichever of these possibilities it needs.
E: Yes. We let the unconscious direct. Whenever subjects, try to do what they
understand [try to direct their unconscious with their conscious], they run into
confusion.
R: I wonder if that throws light on the general significance of confusion when we deal
with personality and inner problems? Confusion is the result of trying to impose our
conscious and more limited understanding on the broader patterns of unconscious
functioning?
E: Confusion results from trying to impose some form of regimentation upon natural
processes.
R: I see. That's how you would define psychological confusion.
E: A centipede can be walking along happily until some son-of-a-gun asks him which
leg comes after which. Then he falls into confusion trying to figure that out. As long as
the centipede does not try to rationalize, he is okay.
R: From a neuropsychological point of view, I wonder if psychological confusion and
error can result from trying to impose the rational programs of the left hemisphere on
the gestalt patterns of the right?

Therapist Voice Evoking Personal Associations


You can learn to hear my voice
as only meaningful sound.
Meaningful sound
to which you give the interpretation.
And it isn't necessary
for you to
waste mental energy
on the realities,
the external realities.
Now I will illustrate that.
(Pause.)
When I was demonstrating in a
hospital, I had some subjects on a stage with me.
They were not in a trance.
I told the audience that the people on stage were going to go into a trance.
While I was doing that, I noticed some people in the audience that were going in a
trance.
They were very still.
I told the people in the audience they could look around and see which of them had
gone in a trance. Some might have to stand up to look around.
(Pause.)
E: I want her to hear my voice as something which evokes memories and associations
meaningful to her.
R: You're trying to associate your voice with meaningful dimensions within her. She can
even reinterpret your words in terms of her own mental sets and personal contexts into
which she places your words.
E: My words are not limited to the words themselves. They will just naturally trigger off
many different associations in her.
R: So you're actually describing another natural mental mechanism here: the process
of association. At the same time you're associating your voice with whatever personal
associations are evoked.
E: That's right, to elaborate their associations at the unconscious level. You've already
told them they don't have to share it all with you, but you do want them to elaborate.
R: You're activating the unconscious, you're getting them moving here?
E: You're getting them moving because there is a lot of territory they can cover.
R: In other words, you want patients to be active in the inner world, not just sitting there
passively.
E: That's right.

Utilizing Inner Realities in Spontaneous Trance:


The Common Everyday Trance
One girl in the audience stood up and looked around.
I told her she could do something she liked to do.
(Pause.)
She nodded her head agreeably.
She would do so.
I worked with the other subjects on stage.
I later asked her to give me some attention.
I asked her to tell me
if she could share it with others,
to tell me what she had been doing
and to explain it.
She said she had been down to the bay and looked all around.
There was nobody in sight so she went in swimming in the nude and had a most
delightful time.
And then she heard my voice from a long distance away. A distance of 50 miles.
It was hard to recognize my voice, because of the distance, asking her to come back
to the hospital room.
She came back and explained how she enjoyed swimming in the nude very much
and often swam nude alone at that place.
She had enjoyed that swim
and now felt very rested,
(Pause.)
refreshed.
(Pause.)
You have done comparable things in your dreams at night.
(Pause.)
You can do comparable things in the trance state.
(Pause.)
You can read a book.
You can go swimming.
You can converse with friends.
And everything will be totally real
because the only reality
that things possess
is the reality that our senses give them.
R: It is not unusual for you to notice the spontaneous trances that people in the
audience fall into while they are apparently listening to you. Their bodies are still, they
typically have a "vacant" or "faraway" look in their eyes, and their faces may be "ironed
out." This sort of trance or reverie is a natural part of everyday life, and you have
developed approaches to utilize these spontaneous trances for demonstration and
therapeutic purposes. The very fact that this girl from the audience did stand up
indicated she was in rapport with you, and your simple suggestion that she could "do
something she liked to do" was sufficient to utilize her spontaneous trance for
demonstration purposes.
E: When she stood up, I could tell she was in a trance by the economy of effort in her
movements: a slow and highly coordinated way of moving.
R: So you utilized her spontaneous trance for demonstration purposes.
E: At an invitation by her.
R: I see. Since she did go into a spontaneous trance and followed your suggestion to
stand and look around, you concluded that her unconscious was asking for a trance
experience directed by you.
(Erickson here gives several other examples of how he detected the unconscious
wishes of experimental subjects and patients and then utilized these wishes in deep
trance to help them achieve them.)
R: This accounts for much of your success in helping subjects achieve significant
objectives in deep trance. By being sensitive to what they want and need and "giving
them permission" to achieve these things, they go into intense periods of inner
absorption (deep trance) focused on their needs and thereby achieve their inner
realization. That accounts for the potency of your clinical, patient-centered approach;
you go along with the natural currents that are there striving for expression. You simply
utilize what is there.
E: And when a patient says, "I don't want to do this," I say, "okay, then I'll take care of it
while you do this other." So they can dissociate.
R: You help them dissociate their negative affect from something that needs to be
done.

Minimal Cues and Unconscious Perception, Not ESP


A blind person
hears and feels
and smells someone else.
He cannot see that person,
but he can hear how tall a person is.
He can tell,
talking with the person,
just by his own speech to the person
he can tell if the body is male or female,
because there is a different sound bouncing off that person's body back to his ears.
He can tell if a person is facing him or has his back to him.
We all have so much knowledge.
of which we are unaware.
(Pause.)
Will you stop to think about it?
We do not know
(Pause.)
which use
of your awareness
of things
you will use.
E: Most people do not know of their total capacities for response to stimuli. They place
mystical meanings on much of the information they get by subtle cues. (Erickson goes
on to explain that the ability to make a subject turn around by looking at their back, for
example, is achieved because the person who turns around has actually picked up
minimal cues from others in the audience who have noticed the looker. If two people
are alone, the same effect is achieved by detecting subtle smells or sounds of the
presence of the other without even being aware that these subtle smells or sounds
were utilized. On numerous occasions people have asked Erickson about the existence
of ESP and other psi phenomena in hypnosis. Erickson simply replies that he has
never personally encountered a situation where such "parapsychological" events could
not be accounted for by minimal sensory cues which people were unaware they were
capable of using.)
R: Yes, many of the mind-reading, thought-reading, and muscle-reading experiments of
the early days in hypnosis (Hull, 1933) can be explained as forms of ideomotor or
ideosensory cues that most people do not ordinarily recognize.

Utilizing Unconscious Cues and Perception


You can drive straight west
and pass
a distant mountainslide.
The landscape impresses you
very
warmly.
Ten years later
in driving east
you recognize that landscape.
One can think
of a situation
without using a single muscle.
Or one can think of a situation
and use only the memories
of muscle action.
Or one can very slightly
use the muscles.
One can remember
a long past fear
and be completely passive
but feel all the memories of that fear.
(Erickson here gives a personal example of memories associated with muscle action.)
And you can make my voice
just a meaningful sound
that you can interpret
in any way that you please.
(Pause.)
And you have no occasion to be
frightened
or excited
or confused
except for your own
desires
and your own
understandings.
You can look at anything
you wish
to see it.
You use your memories
to construct it.
If opening the eyes aids the construction, that's all right.
But you can construct with the eyes closed.
In brief,
there is a wide field of
exploration
for you.
[To Dr. R] Now when a patient has this opportunity to explore themselves, you are
careful not to place any interpretation on anything they do.
E: This is another example of the same thing: you don't know which cues you are
using, but you do remember the landscape. The whole effect is registered.
R. The whole, the gestalt?
E: Yes, the gestalt.
R: So you're telling S by this example to be sensitive to gestalts?
E: I'm telling her, "Don't assume it must be just one cue or fact that you can name in
recognizing things."
R: Why are you telling her this? What are you getting at?
E: You don't know what the cues are that you are using, but you can recognize things.
R: So your unconscious is automatically identifying all those cues and ends up by
telling the conscious mind, "It's so and so" without telling the conscious mind all the
details of how it came to that perception. So you're telling her unconscious to utilize all
its cues.
E: It doesn't have to have a cue that is nameable. The conscious mind tends to think it
has to have identifiable cues, but you don't need specific cues to do things.
R: But why are you giving her this lesson here?
E: Because she's been trained as a psychologist, and one of the defects in teaching
psychologists is they try to make you aware of all the cues to different things.
R: They train you to consciously label everything rather than learning to utilize your
intuition (unconscious perception). With S you must undo some of this overrational
training to force the unconscious to work on its own. This is necessary if she is to
experience hypnotic phenomena wherein the unconscious operates autonomously.
You are thus trying to activate her unconscious by (1) emphasizing all the things it does
well all by itself and (2) depotentiate her over rational conscious orientation by
emphasizing that it is not needed.
E: She has learned in college that you use words and numbers to express everything.
R: That rational approach is good for certain intellectual things, but for total human
functioning it is not good.
E: It's not good!
R: It freezes you up. It limits you to your conscious awareness. It locks out unconscious
perception and mentation. You don't trust your unconscious perception.
(Erickson here tells a charming story of how he and several of his male colleagues at a
convention happened to be standing together watching a young female child hovering
in obvious difficulty in front of a men's room. Dr. Erickson immediately wagered that
she would pick the married man with the most children from among them to take her
into the men's room. With unerring unconscious perception she did. The child did not
stop to think, 'Now the ablest man to help me would be the one who had the most
children and is therefore used to this sort of thing.')
R: So you want S to learn to trust that unconscious knowing and doing in her trance
work. This experience will then help her eventually achieve a better balance between
rational and irrational processes in her daily life.
E: Yes! You don't actually have to look for a wedding ring to spot a married man or woman.

Trusting Unconscious Functioning:


Trance as a Natural Form of Unconscious Functioning
[To S] We learn early that to see things we have to have eyes open. But in
reconstruction of a visual scene you only need the memories.
[To R] There is that lifetime of learning that you have to open the eyes, and so you tell
them they can open their eyes since it may help them.
You give them the opportunity
to open their eyes.
They also know they can
use their nose to smell
and ears to hear,
their fingers to feel.
R: They get all that by implication.
E: Yes, by implication. One can learn by reading,
by seeing,
by feeling,
by being told,
by experiencing,
and the best way of learning, to use folk language,
is by getting the feel of it.
R: To encourage a person to go into trance you must encourage them to trust their
unconscious because trance is a natural form of unconscious functioning.
E: That's right.
R: Our view is that trance is an altered state. Do you go along with the idea that it is a
paleological system of mental functioning—more on the paleocortex rather than the
neo-cortex?
E: Trance is a simpler and uncomplicated way of functioning. (Erickson here gives
examples of how a child learns food preferences, etc., by watching the parents and
siblings reactions to food. These early learnings are based on the simpler and more
direct processes of observation rather than the more complicated forms of learning
involving the mediated use of words and logical thought processes that come later.
Erickson does not believe, however, that trance is an atavistic state.)

Pantomime and Nonverbal Communications to Reach Simpler Levels of


Behavior
You get the feel of a poem,
the feeling of a picture,
the feeling of a statue.
Feeling is a very meaningful word.
We do not just feel with the fingers,
but with the heart,
the mind.
You feel with the learnings of the past.
You feel with the hopes for the future.
You feel the present.
R: You like to use pantomime and nonverbal approaches to trance because they
activate and reach in more deeply to the simpler levels of functioning.
E: Yes. You thereby bypass the enforced rigid forms of later conscious acquisitions.
You don't have to have things put into words.
(Erickson gives examples in courtship. A girl may tilt her head for a kiss, but it would
spoil the situation for her to verbalize her wish.)
You just ruin things with your later learnings. A tilt of the head is far more meaningful
than words.
R: How can we generalize this to trance behavior as a whole? Trance is not so much
regressed behavior as a simpler form of behavior—behavior that is not necessarily
dependent on words and adult patterns of understanding?
E: Yes, it's awfully simple behavior.

Characteristics of Ideomotor Head Signaling in Trance


[S is making slight "yes" head-nodding motions. So slight and slow were the
movements that Erickson had to silently point them out and Rossi had to carefully
study S for a minute or two before he was convinced that they were really taking
place. These slight "yes" responses are apparently S's expression of agreement with
what Erickson was saying.]
(Erickson gives examples of the economy of body movement in trance. Nodding the
head "yes" in trance is very slight and slow; this is in marked contrast to the rapid and
large nodding movements to signify "yes" when we are awake.)
R: You can differentiate conscious from unconscious movements because the latter
are always slower and more abbreviated.
E: If something is very important, then the movement [e.g., head nodding] will be
continuous rather than just once—still slow and abbreviated but continuous so you
really understand. They will continue the head nodding until you give some
acknowledgment that you understand. Repetitive movements in trance mean a thing is
more important.

Turning Problems Over to the Unconscious


Now I would leave
instruction in neurosis primarily to your unconscious.
(Pause)
And I want you to know
that in each person's life
there are things
we like and don't want to know about.
It would spoil the magicians art if you knew
how he did that trick.
How did he get that rabbit out of a hat?
Of course, there is some kind of an explanation,
but you would rather enjoy having him perform
than know how he did it.
All magicians keep their own special secrets,
and they all respect each others' secrets.
[Erickson gives several examples of how he and others have enjoyed not knowing
how magicians performed their mysterious feats.]
And another thing all patients
should keep in mind,
adults are only children grown tall.
R: It seems strange to suddenly pop out with that didactic statement, "Now I would
leave instruction in neurosis primarily to your unconscious." Why did you come out with
that right here?
E: Because [I have prepared her for it with the previous context, where I was giving
many instructions for more freedom for unconscious functioning]. So that statement
would mean, "Leave all the instructions concerning your neurosis to your unconscious.
Let us turn this problem over to the unconscious."
R: Because your conscious mind does not know how to cope with it?
E: That's right. But you do not tell them they cannot deal with it consciously.
R: Again you've taken something out of the biased, rigid sets of consciousness and
given it to the more flexible system of the unconscious.
E: It would spoil the magician's art if you knew how he did that trick. If you want to
enjoy swimming, do not analyze it. If you want to make love, don't try to analyze it.
R: Right, Masters and Johnson even talk about getting hung up in the "spectator" role
in sex, which interferes with sexual experiencing (Masters and Johnson, 1970; Rossi,
1972b).

Facilitating Creative Perception


The unconscious is
much more childlike
in that it is direct
and it is free.
Children have asked me
why I walk that funny way
when their parents had not even noticed that I limped.
They were appalled at the children calling attention to my limp.
The children saw something they wanted an understanding of.
They were willing to reach out for an understanding.
When you have a patient in a trance, the patient thinks like a child and reaches for an
understanding.
E: Patients tend to disparage themselves as being childish during trance, but don't let
them disparage themselves that way. You rob them of that sort of neurosis shelter.
R: Self-disparagement is a neurosis shelter. So you emphasize the creative aspects of
a child's fresh perception and curiosity about the world to loosen patients from their
negative adult bias against natural free inquiry in trance. This is one of the
characteristic ways you attempt to facilitate an attitude that will encourage them to take
a fresh look at their problems from new points of view.
E: Juvenility is far superior to senility.

Protecting the Subject


Your task is to protect him.
R: To protect him?
E: To protect him so he doesn't get alarmed at what he discovers.
E: When patients came in to stop smoking, they may say when in trance, "I don't really
want to stop smoking." The therapist then sees physical alarm; they now know the truth
about themselves. So you say to them, "I don't think you should know that when you're
awake yet." You protect your patient. You're protecting the conscious mind by keeping
that self-understanding unconscious.
R: Because the conscious mind should not have its sets shattered too rapidly.
E: Yes, that can be a shattering experience unless the patient has the strength to
endure it.

Lies in a Trance
An example is in lying. Children are entitled to tell lies. They are entitled to see things
as they are without being frightened.
E: When a person in a trance says something you know is a lie, you better look it over
because it has another meaning.
R: It has meaning other than being a lie?
E: Yes. In some way the person is telling the truth. A truth as seen from a totally
different point of view. And bear in mind that you as the therapist also have your own
set and rigid points of view to deal with.
R: Would lies in a trance also be an indication of regression to a more childlike state?
E: It's a regression to a more simple mode of functioning, less complicated. A person
may tell you of going to a circus in Wisconsin, yet they have never been to Wisconsin.
That may mean they are identified with somebody in Wisconsin. This is their way of
telling you about an identification when they don't have a vocabulary to permit them to
say, "I identify with so and so."
R: They express an identification by attributing something about the other to
themselves. This kind of psychological language accounts for many of the so-called
lies and distortions expressed in trance.

Conscious and Unconscious as Separate Systems


A child will drop a glass on the floor and say with wonderment, "It broke!"
And not necessarily have to react with adult understanding that it was a valued
antique.
(Pause.)
Every patient needs to know that the emotional content of something can be
experienced with no knowledge of what caused the emotion.
(Pause.)
A patient can also recall the intellectual memories of an event as if they happened to
someone else.
Many other things have no meaning to the self, and then later the emotions and
intellectual content gets together
piece by piece, like a jigsaw puzzle.
E: It's well to let them experience this state of wonderment in the trance.
R: That would mean that in the trance state their unconscious is free from the biases of
the conscious mind?
E: Yes. It shows the unconscious can forget what the conscious mind knows. It may
leave certain knowledge in the conscious mind.
R: I see. So the conscious and unconscious really are separate systems?
E: Yes, they are separate systems.
R: Do you have any therapeutic goal for the ideal mode of psychological functioning? A
certain amount of interchange between the conscious and the unconscious, for
example?
E: The ideal person would be one who had a readiness to accept the interchange
between the conscious and unconscious. Children are uncluttered by rigid conscious
sets, and therefore children can see things that adults cannot.

Right- and Left-Hemispheric Functioning in Trance


I taught my sons the best way of hoeing a garden.
You have a square yard at
the northeast corner,
a square yard at the northwest corner,
and then the southeast and the southwest.
Now that you have hoed a square yard at all corners, you hoe a square yard in the
center. Then hoe a line from the middle to a corner.
Now you're making a design of the garden.
That is a very interesting way of doing a laborious piece of work. You become so
interested in the design that it's a pleasure.
In working at a problem of difficulty, you try to make an interesting design in the
handling of it.
That way you have an answer to the difficult problem.
Become interested in the design and don't notice the back-breaking labor.
In therapy that is often a very delightful thing to do.
(Pause)
When you do work freely and willingly,
one has a right to take a rest period at any time.
You are free to resume work at any time.
Free to alter the design and pattern in which the work is done.
One can do automatic writing from right to left or left to right.
[Erickson here gives a detailed clinical example of a child who wrote backwards and
upside down and from right to left but not the conventional way. Rather than attempt
to correct the child by prohibiting his unusual ways of writing, Erickson pointed out to
the child his superiority in being able to write in three different ways while Erickson
could only write in one: the conventional way. Erickson then proceeded to try to learn
to write one of the ways the child did, and the child, to maintain his superiority, now
wanted to learn yet another way of writing—the conventional way. He was now
learning his fourth way of writing while Erickson was still struggling to learn his
second.]
E: Another simple technique of distracting consciousness from a laborious piece of
work.
R: So here again in this lengthy example you're telling S to let go of her conscious sets
and orientation because they are so laborious. You are suggesting that she substitute a
kind of creative, aesthetic play with patterns for the hard work of hoeing in laborious
linear rows.
Throughout this and many previous sessions many of your efforts could be understood
as distracting or depotentiating the linguistic, rational, linear, and directed modes of left-
hemispheric functioning in favor of the spontaneous perceptual-aesthetic, kinesthetic,
and systhetic modes of right-hemispheric functioning. Dream, reverie, and trance have
recently been characterized as right-hemispheric functions. When you emphasize
trusting natural or unconscious patterns of functioning in trance, you are actually
emphasizing the paralogical or appositional (Bogen, 1969) characteristics of the right
hemisphere. It may well be that future research will establish that much of what we
have until now characterized as the dichotomy between the conscious and
unconscious (secondary and primary process thinking) is neuropsychologically a
dichotomy between left- and right-hemispheric functioning. From this point of view
many psychological problems could be understood as the erroneous imposition of
rational left-hemispheric approaches to situations that could be better dealt with by the
right hemisphere.

Training the Modern Mind to Rely on the Unconscious


Now the next thing I want to say to you is this: It is never necessary when you sleep at
night to remember your dreams the next day.
It's possible to dream tonight
and wait a year before you remember
the dream.
You may remember a part of the dream
tomorrow and part of it next week.
Your remembering the dream
has to be in accord
with what you need.
You don't have to remember.
The important thing is to have
certain experiences
recorded in your mind.
Some day their presence will be of service to you.
It is necessary for you to be aware
that you know they are there.
The important thing always is
to do the right thing at the
right time.
To know that you can rely on yourself.
To let your unconscious feed to you
the right information that permits you
to do the right thing at the right time.
It may be this year or
next year
or two years from now.
(Pause)
R: You are again illustrating the unimportance of consciousness relative to the
unconscious in trance. With all these examples you are telling S that she can rely on
her unconscious. This approach is needed with S because she is, relatively speaking, a
highly intellectualized person with a Ph.D. This approach of retraining the patient to rely
on the unconscious is going to become more important in the future as more and more
people become highly intellectualized. Direct authoritative suggestions may have been
appropriate 100 years ago, when it was possible to reach the unconscious that way.
But the modern hypnotherapist has to help people relearn that natural mode of
functioning where they leave things to their unconscious.

Indirect Posthypnotic Suggestion


An illustration is when you awaken. One of the most pleasant things you have to
experience is in coming out of the trance
thinking you are ready to go into a trance
for the first time.
And then becoming aware that you must have been in a trance.
Maybe the degree of light outside indicates that.
The indication is from the outside.
That can be assessed by you
as a beautiful learning experience.
(Pause)
R: This is an example of an indirect posthypnotic suggestion. First you carefully lay the
groundwork by talking about forgetting dreams until it is the right time to remember
them. You thereby hope to evoke forgetting mechanisms. Just as she can forget a
dream until it is important to remember it, so can she, by implication, forget she was in
trance until it is important to remember it. You then administer the indirect posthypnotic
suggestion. You don't directly tell her to forget she was in trance. That might only evoke
the typical reaction of consciousness, "But I don't know how?'" Instead, you describe
the kind of pleasant experience she can have "coming out of the trance thinking she is
ready to go into a trance for the first time." Instead of giving a direct suggestion to do
something consciousness would find difficult, you simply motivate her for a "pleasant"
experience. You talk about the degree of daylight outside as an indication of the
passage of time. Perhaps that will be the only cue that will enable her to recognize she
was in trance for some time. You also prepared for this earlier when you talked about
the way the unconscious uses cues and the value of relying on the unconscious to do
things.
Thus, during the earlier part of this session you were laying an important foundation for
this seemingly casual posthypnotic suggestion. You were building an associational
network and activating mental mechanisms that might be utilized to facilitate forgetting
in an entirely autonomous or dissociated manner.
E: Yes, you are always building one thing on another and relating what you are saying
now to what you said earlier.

Depotentiating Consciousness:
Analogies of Lapses in Consciousness
In everyday life
you overhear people saying to themselves,
"Now just how did I do that?"
What they mean is,
they don't know how they did it.
They have only an incomplete view of how they did it.
They then have to recover
step by step
the manner in which they did it.
R: Experiencing and learning come before understanding.
[Erickson here gives several clinical examples of how he recognized minimal cues of
hand, eye, and lip behavior that indicated that certain patients did not really want to
give up smoking even though they presented themselves in therapy for that purpose.
These examples illustrated the difference between conscious purpose and a deeper
understanding of motivation.]
R: Here you're giving examples of lapses in consciousness in everyday life. By simply
mentioning these possibilities you hope to facilitate their occurrence in S as a means of
depotentiating her consciousness so she can learn to rely more on her unconscious.

Accepting Spontaneous Awakening


[Much of the above actually appeared to be a conversation between Erickson and
Rossi. S apparently felt abandoned and began spontaneously to awaken, as was
indicated by minimal movements of her lips, nose, forehead wrinkling, and some
finger movements. Erickson notes this and remarks that she is awakening and getting
ready to talk to us.]
S: What do you want to know?
E: Only what you want to tell us.
S: Well, I was jumping around a lot. When you were saying I was trying to wake up, I
actually had already abandoned the idea because my hands were so heavy I couldn't
move them. But when you said I was waking up, I tried to wake up again. But I'm kind
of curious why you don't follow through with someone who is in trance. Like when I do
hypnotherapy, I stay right with the patient the whole time, and then when I judge it's
right, I say you can count to wake up or whatever. Why don't you do something like
that?
R: Yes, Dr. Erickson, why don't you behave like a regular hypnotherapist should?
R: Here you accepted her spontaneous awakening and utilized it as part of a hypnotic
suggestion by simply remarking on it and helping it happen further. People are
continually going in and out of trance, so when they are coming out you may as well
utilize that behavior to strengthen the hypnotic relationship rather than contesting it and
setting up a battle of wills between therapist and patient. You can be with them whether
they are in or out of trance.
E: You may as well join them when they come out, and later they will join you in
following your suggestions more easily. You always give the patient approval for what
she is doing.
R: There is no need for the beginning hypnotherapist to panic when a patient
spontaneously comes awake. That's just their natural mode of functioning and is to be
accepted as a way of strengthening the hypnotic relationship.
E: If it is their way of functioning, you'd better go along with it.
R: The therapist is not really in control of anyone.
E: That's right!

Alternating Rhythms of Suggestibility


R: There are only moments when the therapist can effectively direct something the
patient wants to experience. But it is "touch and go—touch and go." Moments when a
suggestion can be accepted alternate with moments when they cannot.
E: And the therapist can remain comfortable in that situation.
R: Yes, this is very important for the beginning therapist to learn: there is a natural
rhythm in patients that the therapist learns to recognize and go along with. 1 used to
get all tense in working with patients by thinking, "Oh, this is not working, that doesn't
work either, the whole thing's not happening." Such an attitude I now see is ridiculous.
E: It is so ridiculous! You never give the patient the impression that you must be
constantly alert. You give them the impression that they are always sharing in the
responsibility for the success of the work. S had expressed her belief that when she did
hypnotherapy she had to stay right with the patient all the time. Therefore when I
appeared to be distracted, that gave her reason to wake up.

Trance Training and Utilization


S: What is the logic of what you do?
E: In a learning situation you have to do your own learning. I want you to learn a lot
faster than I did. It took me about 30 years to learn, and there is no sense in that. Now
if I were treating you for a problem, I'd stay with you and give you support at different
points. But you are in a learning process, getting the feel of everything.
S: But this way I just trip around till I'm bored and then come out of it.
E: Are you sure you come out of it because you are bored?
S: It's almost as if I fell asleep because I caught myself nodding a few times.
What was happening on your left side, some distance off to the left? Were you looking
for something?
[Erickson now puts a detailed series of questions to S regarding the subjective
experiences that were associated with her behavior in trance, such as eye and head
movements to the left and right, minute movements of the face, breathing alternations,
etc. In an amazing way Erickson revealed he had actually observed many more details
of S's trance behavior than she could recall.]
R: With this question S reveals her highly rational approach. That is why you've spent
most of this session telling her to give up consciousness control. Could you elaborate
here on just what you want her to learn on her own? This appears almost like self-
hypnosis, where the person has to do it all on their own. You're telling her to learn to let
things happen?
E: That's right.
R: If an itch happens, fine, go along with it. If heaviness happens, fine, go along with it.
If memories happen, fine! If you flash and trip around in your head, fine!
(Erickson here tells an amusing anecdote about a husband and wife trying to outdo
each other in growing tomatoes. A few days after planting them the wife decided they
needed more sun, so she transplanted them. Later it seemed to her they needed more
shade, so she transplanted them again—and so on. She was still transplanting them
when her husband was harvesting his tomatoes.)
R: So what's the relevance of that story for what we are discussing?
E: You let the subject grow!
R: Oh, they learn to do their own thing at their own pace. You let them grow and not
interfere with their natural growth process.
E: My learning over the years was that I tried to direct the patient too much. It took me
a long time to let things develop and make use of things as they developed.
R: That accounts for your development of utilization techniques—one of your basic
contributions to modern hypnosis. You utilize the patient's own behavior to initiate
trance, self-exploration, and the like.

Failure of Suggestion by not Meeting Patient's Needs


S: When I tried to lift my arms toward the end in an effort to awaken, I got dizzy.
E: Why do you think you got dizzy?
S: It was like when you first wake up in the morning and you are very groggy. It was a
disorientation, as if I could be tipping all sorts of ways. It was a strange body
sensation. ... I was myself enjoying the trance in the beginning; then I became the
therapist, wondering why the heck you weren't telling me what to do.
R: I think S has been getting impatient with us.
E: Impatient in a curious way, and that is always a barrier.
S: Well, I guess I want to know the practical things about hypnosis: what it is, how you
deal with problems, how you deal with smoking, weight problems, etc.
R: S is used to intellectual learning rather than the experiential learning of trance.
[Erickson terminates this session by giving several examples of experiential learning
and knowing versus intellectual learning.]
R: You attempted to extend her trance training in this session by giving her an
interesting posthypnotic suggestion to forget she was in trance. To carry out that
suggestion successfully, she would have to rely on her own unconscious, as she did in
her last session when she experienced that marvelous age regression, hypermenesia.
But in this session she was irritated because you did not meet her preconceived
expectations of how closely attentive you should be to her during trance. Because
these more personal emotional needs were not met, your indirect posthypnotic
suggestion paled into insignificance and was not received. That she was experiencing
trance is indicated by the heaviness of her hands, but then the therapist observer within her
may have gotten in the way of further experiential learning in this session. This is a clear
indication of how important it is to recognize and meet in some way the patient's emotional
needs before we can expect them to relax to the point where they can rely upon their
unconscious to carry out suggestions.

TRANCE TRAINING AND UTILIZATION


Erickson makes a highly significant statement in this commentary, "My learning over the
years was that I tried to direct the patient too much. It took me a long time to let things
develop and make use of things as they developed." This entire session with S was an effort
on Erickson's part to train her to allow things to happen spontaneously, unconsciously. The
most basic learning in hypnotic work is to let things to happen of themselves, to let the
unconscious function as free as possible from the learned habits and programs of
consciousness.
It took Erickson a long time to learn that this is the first essential in all sound
hypnotherapeutic work. Patients are patients because they are out of rapport with their own
unconscious. Trance allows the patient to experience his own unconscious free, to some
extent, from the limitations of his conscious sets. Once this unconscious mode of functioning
becomes manifest, then Erickson feels free to help the patient utilize it for therapeutic
purposes.
Therapeutic hypnosis is not just another technique for programming patients. Patients
are people who have had too much programming—so much outside programming that they
have lost touch with their inner selves. Therapeutic trance is an experience wherein patients
receive something from within themselves. The astute hypnotherapist is one who arranges
circumstances to permit such receptivity to inner experience. He helps the patient to
recognize the value of his unique inner experience and provides suggestions about how it
may be utilized therapeutically.
We may note that this way of defining therapeutic trance is very similar to the classical
use of meditation. The word "meditation" comes from the Latin meditari, a passive form of the
verb that means literally "being moved to the center." Consciousness remains passive as it is
moved to the center (the unconscious), where it can achieve wholeness: a reunion with
contents and tendencies that have been excluded from consciousness (Jung, 1960).

THE DYNAMICS OF INDIRECT AND DIRECT SUGGESTION


Erickson's use of a boring explanation of arithmetic to fatigue Dr. S in this session reveals
some basic principles of his use of indirect suggestion in a particularly clear manner.
Erickson did not directly suggestion that she would be relaxed, tired, or fatigued. Rather he
used an arithmetic explanation as a stimulus (Sarithmetic) for evoking an external response of
being polite (Rpolite),which in turn evoked within Dr. S an internal response of boredom
(rboredom) which led her to feel fatigued (Rfatigue). This process of outer stimulus, internal
mediation, and behavioral response can be outlined as shown in Figure 1. There is little or no
identity between the suggestion (Sarithmetic) and the final response (Rfatigue) that the subject can
recognize or influence in any way.

Sarithmetic Rpolite rboredom sboredom Rfatigue


Figure 1. The process of indirect suggestion with no obvious relation between the suggestion (Sarithmetic) and
response (Rfatigue)- The large letters represent overt, external, objective events, while the small letters (r and s)
represent covert, internal, subjective events that are usually not understood or even recognized by the patient.

Direct suggestion, by contrast, presents subjects with a stimulus that identifies what the
response should be. Frequently the therapist offering direct suggestions will actually tell
subjects exactly what internal processes they should use to mediate the response. In giving a
direct suggestion the therapist can only hope the subject will cooperate with this exact
suggestion or find other internal processes by which the response can be mediated. How the
response is mediated within is sometimes understood at least in part by the subject. When
they are successful, subjects usually report that they imagined themselves in a fatiguing
situation, for example, and then by association they managed to evoke a response of fatigue
they could actually feel. Some investigators (Barber, Spanos, and Chaves, 1974) actually
train their subjects to use conscious ideation in this way. Direct suggestion could be
diagrammed as shown in Figure 2, where there is a clear identity between the initial
suggestion, the internally mediated responses, and the outer response that the subject can
recognize and influence.

Sfatigue rfatigue Sfatigue situation Rfatigue

Figure 2. The process of direct suggestion with an obvious relation between the suggestion (Sfatigue) and the
response (Rfatigue). The internal mediating responses (rfatigue —> Sfatigue situation) are in part recognized and
understood by the patient.

Direct and indirect suggestions can both achieve effective results, but they are mediated
in different ways such that their relations to consciousness and volition are different. Direct
suggestion is mediated by internal processes that the subjects usually have some awareness
of. The subjects recognize that they made the response happen. The response is more or
less under voluntary control. Indirect suggestion, by contrast, is usually mediated by internal
processes that remain unknown to the subjects. The response, when it is noticed, is usually
acknowledged by the subjects with a sense of surprise. The response appeared to occur in
an involuntary and spontaneous manner. It has a curiously dissociated or autonomous
aspect that is usually acknowledged as "hypnotic."
A problem with direct suggestion is that the responses obtained may simply be voluntary
compliance on the part of the subjects. They may simply be trying to please the therapist in a
fully conscious way. Thus, theorists who have identified hypnosis and trance with
suggestibility (compliance with direct suggestions) have been led to a downgrading of the
autonomous or involuntary aspects of hypnotic experience. Thus, we have theories of trance
as voluntary role-playing (Sarbin and Coe, 1972) or a form of voluntary conscious
cooperation in thinking and imagining along with the theorist's suggestions (Barber, Spanos,
and Chaves, 1974). These are all actually theories of direct suggestion. An unconscious or
involuntary component is not necessarily evident when a subject accepts and acts on a direct
suggestion.
With indirect suggestion, however, subjects usually do not recognize the relation
between the suggestion and their own response. There thus can be no question of voluntary
compliance with the therapist's suggestion. If a response does take place, then it has been
mediated by involuntary processes outside of a subject's immediate range of awareness.
This involuntary mediation of responses is what we use to define the genuineness of trance
behavior. The involuntary or autonomous response that surprises consciousness is what
differentiates hypnotic from ordinary awake behavior. Such autonomous responses can be
elicited by direct suggestions—(e.g., all the suggestions of the Stanford (Hilgard, 1965 and
the Barber et al. (1974) hypnotic suggestibility scales—but with direct suggestion there is
always the problem of simulation: Did the response take place in a voluntary or involuntary
manner? With indirect suggestion, however, the very appearance of a response can be a
satisfactory criterion of its involuntary nature, since the subject is unaware of why or how it
happens.
Weitzenhoffer (1957, 1974, 1975) has emphasized that the defining feature of hypnotic
suggestion is the absence of conscious volition in the production of the hypnotic response.
We agree with this basic formulation. In order to take a preliminary step in making a
distinction between direct and indirect suggestion we have discussed the role of conscious
awareness and intention in our formulation above. In direct suggestion it is possible for the
patient to have some conscious awareness of how the hypnotic response is mediated within
and may in consequence attempt either to inhibit or to facilitate the hypnotic response with
conscious intentionality. With indirect suggestion care is taken so that the typical patient will
not become aware of how the hypnotic response is mediated within; hence there is less
opportunity for conscious intentionality either to facilitate or to block the response.

INDIRECT CONDITIONING OF TRANCE


Erickson's use of indirect eyelid conditioning in this session is another prime example of
his indirect approach. He labels a slow eye blink (associated with trance) with the word "odd"
and a fast eye blink with the word "even." The subject did not know the connection between her
eye blinks and the words. An association can be made between the rapidity of eye blink and the
words "odd" and "even" without conscious awareness. Once this association is made, then
saying the word "odd" will tend to evoke slow eye blinks, and since slow eye blinks are
associated with the beginning of trance (by previous eye fixation induction as well as by everyday
life experience wherein we do begin to blink slowly as we drift into altered states like daydreaming
and sleep), subjects find themselves drifting into trance without knowing exactly why.
Erickson actually uses many forms of indirect or incidental conditioning that take place all
by themselves. Often he relies on nothing more than the natural processes of associational
conditioning that are formed between trance experience and the situation in which the first
trance occurred. Subjects who have successful experiences with trance the first time they
come into Erickson's office will have many associative connections built between trance
experience and Erickson as a person, his voice, his manner, and other characteristics. There
will be associative connections between trance and the subject's presence in the office and
sitting in the same chair as the first time. There will be associations between the appearance
of the room, the presence of the cut-glass paperweight that Erickson usually uses as a point
for eye-fixation induction, etc. Indeed, for some subjects the simple behavior of going to an
appointment with Erickson is enough to initiate the expectation of trance so that inner
adjustments are being made to facilitate the trance experience even when the subjects are
on their way to an appointment.
Erickson simply watches for these natural processes of conditioning the experience of
trance. When patients enter the office, Erickson carefully observes their behavior for the
subtle signs of trance. Many of these are standard signs that are fairly applicable to most
people: slow eye blink, economy of movement, smoothing of facial features, response
attentiveness, and so on. Some signs are characteristic of an individual: a part of the body
held in an inconspicuous catalepsy (e.g., the finger of one hand bent in a characteristic way),
a particular gaze or manner. When Erickson sees these signs of naturally conditioned trance
behavior emerging, he simply adopts his own usual manner when inducing a trance. He will
look at the patient with his characteristic attitude of expectancy. He may look meaningfully at
the cut-glass paperweight. He might take a deep breath and visibly relax. He might even
close his eyes for a moment. These are all nonverbal cues for patients to enter further into
the trance they may already be experiencing. Patients are surprised to find how easily trance
develops, and they frequently have no idea of how or why. Even when patients have some
intellectual awareness of how they have been conditioned to experience trance, they find it
more comfortable to go along than to resist. Yet, if patients want to resist the developing
trance, they certainly can. Such indirectly conditioned trances develop to a significant degree
only in an atmosphere of trust, comfort, and cooperation, where there is an expectation that
something will be gained from the experience.

Exercises with Indirect or Incidental Conditioning of Trance


1. Learn to observe your patients carefully as they enter the therapy situation after
having had a trance experience during the previous session. Can you discern signs of
developing trance?
2. Carefully study your own physical office situation and induction procedures to
discover what incidental associations are being formed between your patients' trance
experience and the physical characteristics of the setting and your own behavior. Plan how
you might utilize these to facilitate later trances.
3. What nonverbal cues can you learn to utilize to reinduce trance in your previous
subjects? Many of these will be the slight alterations in your own behavior as you are
facilitating trance experience in your subjects. It may help to have a trained observer present
to help you recognize subtle behavior changes that you do not recognize yourself.

VOICE DYNAMICS IN TRANCE


Erickson's use of voice dynamics is another major approach to indirect suggestion. This
use of voice dynamics ranges from simple direct suggestion that his voice will evoke
personal associations to indirect conditioning wherein he associates the locus of his voice to
different processes within the subject.

Alternating Attention to Therapist's Voice as an Indication


of Trance Experience
In the traditional style of direct suggestion the therapist often tells the patient to pay
attention to the therapist's voice and ignore everything else. That is an effective approach
with direct suggestion. For indirect suggestion, by contrast, Erickson will typically tell patients
that they do not have to bother listening to his voice. When patients later report that during
trance they lost track of Erickson's voice and did not always know what he was talking about,
it can be taken as an indication of the typical development of trance. Initially many subjects
report an alteration in hearing and not hearing or paying attention. This spontaneous
alteration may correspond to the spontaneous alteration of trance depth that is a
characteristic feature of hypnotic experience.

Therapist Voice as Vehicle for Projection


In this session Erickson suggested that Dr. S could learn to hear his voice only as a
meaningful sound to which she would give an interpretation. That is, the content of Erickson's
words could be ignored. The sound of his voice could become a vehicle carrying Dr. S's own
projections. Frequently Erickson will suggest or imply that what he says is not important. Only
the patient's interpretation of what he says in important. Because of this he will use words
with multiple meanings, puns, incomplete sentences, and dangling phrases, so that the
patient's unconscious can project meanings that are important to itself.

Voice Locus and Volume for Spatial-Perceptual


Associations
One of Erickson's unique contributions to the use of voice locus is what we might call its
spatial-perceptual associations. As he talks about associations and memories back in the
past, he may tip his chair backward away from the patient, lower his voice, and even turn his
head away from the patient, so that it seems as if his voice is coming from far away. Just as
the voice is far away, so will the patient's memories come from far away in their dim past. As
those memories stir and become available to the patient's awareness, Erickson may
gradually tip his chair forward and come closer to the patient and speak more clearly and
loudly. But his manner is always subtle, so that the patient does not recognize what he is
doing.
The patient's unconscious, however, may utilize these differences in voice locus and
volume as stimuli that evoke altered patterns of association that may make valuable
memories available. In one striking demonstration with a subject who was visualizing a
suggested scene with her eyes closed, Erickson would raise the pitch of his voice and
actually project it upward by looking up when he wanted her to see something up in the air
and vice versa when he wanted her to see something lower on her internal visual screen.
The movements of her closed eyes were observed to follow the locus and pitch of his voice
exactly. The patient later remarked about the peculiar alteration in the height at which the
suggested images appeared to her. Erickson (1973) has reported how voice locus can be
used to induce sea sickness, vertigo, and similar conditions.

Voice Locus for Conditioning Conscious and Unconscious


Levels of Receptivity
One of Erickson's most interesting but controversial uses of voice locus is his effort to
direct suggestions selectively to the conscious and unconscious of the patient. As he goes
through his induction talk, Erickson may shift slightly to the right every time he mentions the
word "conscious" or talks about obviously conscious matters of interest. He shifts slightly to
the left whenever he uses the word "unconscious" or talks about involuntary and autonomous
processes that are usually mediated without voluntary conscious control. Without the patients
realizing it, they are being conditioned to associate conscious voluntary processes with voice
locus coming from the right and unconscious or involuntary and disdissociated processes
with voice locus on the left. Once these associations are established, Erickson can beam a
suggestion to a conscious or unconscious level by shifting his voice in the appropriated
direction. It will be a matter of future empirical research and practice to determine the
effectiveness of this procedure and the degree to which others can learn to use it effectively
in a systematic way.

Exercises with Voice Dynamics


1. Study tape recordings of your own voice during therapy sessions and in everyday life
situations to become more familiar with your own natural voice dynamics in different
circumstances and what you are consciously and unconsciously communicating.
2. Study recordings of your voice before and during trance induction to learn what
changes you usually make and how these changes may be facilitating or interfering with
trance development in your patients.
3. The actual conscious utilization of one's own voice dynamics requires some practice.
The object is to use voice dynamics in a way that does not arouse the patient's conscious
attention. Otherwise their purpose may be largely lost. One can begin by learning to speak a
bit softly when one wants to obtain the listener's closer attention. One can then learn to
speak more slowly when one wants to help a listener slow down. One can practice speaking
just a bit more loudly and distinctly when one wants a patient to arouse from trance.
4. Explore the use of voice locus in conditioning subjects to receive suggestions at
different levels of awareness. Can you devise new field experiments (Erickson, 1973) or
more controlled experimental situations to assess the effectiveness of this use of voice
locus?

INTERCONTEXTUAL CUES AND INDIRECT SUGGESTIONS


The lengths to which Erickson will go in utilizing all sorts of inter-contextual cues as
indirect suggestion is indicated in the following dialogue.
Erickson: I had some repetitive dreams last night about some things that should be said about
this. In giving suggestions and instruction to hypnotic subjects in the trance state, it is not only
what you say, but it is what they hear, that is important. I can give you an example.
Let us say there is a village named Sunflower in Arizona. Let us take another imaginary
place we will call Weldon's ditches. You carry on a casual conversation about Arizona and
you mention Suntower. Rather than Sunflower. You purposely say Suntower. The person
listening automatically and unheedingly corrects you and doesn't know that you actually said
"Suntower." In talking about the southern part of Arizona and strip mining you mention
Welson's Britches (instead of Ditches).
Now you have said two things outrageously wrong and the subject has consciously
corrected what you said. So consciously they think you said Sunflower" and Weldon's
Ditches. But the unconscious heard you say Suntower and Britches. They detect and
remember that. You can later use that because they don't know why they are impelled to talk
about a flower and a Dutchman's Britches.
Rossi: They are impelled to use those associations which you placed in their unconscious.
Erickson: Yes. They may then talk about that "Devils Tower" in the Caribbean and have no idea
of how you got that association across to them. But you know how you have done it. They can't
consciously ever figure it out. Their consciousness corrected for their conscious mind, but their
unconscious heard it.
Rossi: Your error remains lodged in their unconscious, striving for expression.
Erickson: It is lodged there in the unconscious, and you can keep on talking and drive the
conversation in such a fashion that the discussion of wildflowers brings up Dutchman's Britches
and the Devils Tower in the Caribbean.
This rather extreme example may be characterized as one of placing associations within
the patient's unconscious and then allowing the unconscious to utilize them in its own way. A
more common practice is Erickson's habitual use of pauses that break up his sentence
structure into phrases, each of which can have its own meaning that can be entirely
independent of the meaning the sentence has as a whole. In our transcripts of the induction
section of each session we made an effort to note these important pauses. The separate and
independent meaning of each phrase can be described as intercontextual cues and
suggestions that are picked up and partially processed by the unconscious, while the
conscious simply waits for the remainder of the sentence. These phrases buried in the
context of the sentence thus function as another form of indirect suggestion.
This use of phrases as separate suggestions buried within the broader context of the
whole sentence is actually another form of interspersal technique (Erickson, 1966b). Erickson
has illustrated the uses of interspersing suggestions within the broader context of a general
conversation about a topic the patient can easily identify with (e.g., a general conversation
about growing plants with a farmer, caring for children with a mother, and so on).
Interspersed in this conversation is a pattern of suggestions that come at random intervals
(frequently with a slightly different intonation of voice) so they are unpredictable by the
subject. The interspersed suggestion comes at an unexpected moment, it is short, it is
usually a truism that is not arguable, and the therapist quickly moves on to the general
conversation before the patients can react to the suggestion. The suggestion is received, but
the patients have no opportunity to resist it with their habitual associations, limiting frames of
reference, or other inhibiting factors.
The general conversation that is of interest to the patients has the following functions as
a vehicle for the interspersed suggestions.
1. The general conversation facilitates the development of an accepting or "yes set,"
since it is a topic of interest to the patients. The interspersed suggestion is thus received with
acceptance along with the overt message that is motivating to the patients.
2. The general conversation keeps the patients "awake" at an optimal level of receptivity
rather than drifting to the border of sleep and its uncertain receptivity.
3. The topic of interest facilitates patients' rapport with the therapist, rather than have
them drift too far off into their own associative matrix, which might again result in uncertain
receptivity.
4. The interspersing of suggestions within a familiar and redundant message facilitates a
structured amnesia (Erickson and Rossi, 1974) for the interspersed suggestions and thus
prevents a patient's usual associative structure from interfering with the suggestions.
The intercontextual cues and suggestions buried within the general context of a sentence
would appear to function in the same way as the interspersed suggestions in the context of a
general conversation as described above.

Exercises with Intercontextual Cues and Suggestions


1. Review the induction sections of all previous sessions to study the intercontextual
cues and suggestions that are present in the phrases but not in the sentence as a whole.
2. On the other hand, note how at times the separate phrases of each sentence have
the same implications as the total sentence. In such cases the phrases can summate and
greatly reinforce the suggestion contained in the sentence as a whole, but without belaboring
the point and possibly arousing the limiting reactions of an awakened consciousness.
3. Notice how often in previous commentary sections Erickson brings attention to this or
that phrase as a separate suggestion buried within a more general context. It wasn't until this
session, however, that it finally dawns on Rossi that Erickson was trying to teach another
indirect approach to suggestion, which we have now labeled "intercontextual cues and
suggestions."
4. In actual practice it is very easy to learn how to administer inter-contextual cues and
suggestions. Simply tape record your sessions and later study the transcripts to note what
intercontextual cues and suggestions you are unwittingly giving. As you become more
sensitive to your own buried suggestions, you will develop a heightened awareness of what
you are saying when you actually say it in the therapy sessions. Soon you will welcome the
pauses in your sentence structure to savor your intercontextual cues and bring them under
greater control. As you administer a phrase and carefully watch the patient's face, you can
study the patient's involuntary response (wincing, smiling, etc.) to each separate phrase. This
can give you a sense of the reality of intercontextual suggestions. You will then be able to
utilize these immediate patient responses as a kind of feedback to make you more aware of
the effect your words are having on the patient's associative structure. You can then learn to
orchestrate your phrases and the patient's responses to more adequately effect the
therapeutic harmonies you are attempting to create together.

RIGHT- AND LEFT-HEMISPHERIC FUNCTIONING IN


TRANCE
In our efforts to conceptualize Erickson's understanding of trance and its facilitation we
have used a number of different models:
1. The psychodynamic model of the conscious-unconscious system
2. The learning theory model of behavioral psychology
3. A linguistic model utilizing multiple levels of communication.
From this session it is finally clear that a neuropsychological model utilizing the
differences between right- and left-hemispheric functioning is also implicit in Erickson's work,
even though he developed his views and skills long before the recent studies of hemispheric
functioning (Sperry, 1968; Gazzaniga, 1967; Bogen, 1969). These studies suggest to some
investigators that experiences of trance, reverie, and dream are all characteristic of right-
hemispheric functioning, while the rational, logical, and verbal modes of functioning are more
characteristic of the left. A summary listing of the differences in hemispheric functioning that
can be related to Erickson's emphasis on the differences between awake and trance
experience is as follows:
Left Hemisphere (Awake) Right Hemisphere (Trance)
Linguistic Pantomime, kinesthetic, musical
Logical-Grammatical Visuospatial
Rational Intuitive
Abstract Literal-concrete
Analytical Perceptual-synthetic
Directed Spontaneous
Focal Diffuse
Effort Comfort
From this dichotomy it is clear that much of Erickson's efforts to facilitate trance
experience are directed to depotentiating left hemispheric functioning. The hallmark of left-
hemispheric functioning is the linguistic and logical-grammatical organization of
consciousness, which is usually related to the location of the speech center in the left cortex.
Many of Erickson's nonverbal, pantomime, and indirect approaches to trance induction are
obviously means of shifting consciousness away from this linguistic specialization of the left
hemisphere. As we have discovered in this volume, many of Erickson's habitual forms of
verbal expression are actually designed to jam or depotentiate the orderly, rational, abstract,
and directing functions of a subject's usual modes of left-hemispheric knowing. His use of
shock, surprise, dissociation, shifting frames of reference, confusion, paradox, and double
binds are thus all directed to depotentiating the left hemisphere. His emphasis on body
language, cues from voice locus, emphasis, rhythm, etc. are all shifts away from the rational
and analytic to the perceptual, kinesthetic, and synthetic of functioning so characteristic of
the right hemisphere. When he uses hypnotic forms like implication, expectancy, partial
remarks, and dangling phrases, analogies, metaphors' puns, and folk language, he is again
shifting away from the abstract and analytical to the intuitive and synthetic modes of the right.
Many of the most characteristic features of trance experience such as reverie, dream,
literalism, comfort, and the autonomous or spontaneous flow of mental experience and
behavior are all facilitated by hypnotic forms such as not doing and not knowing, open-ended
suggestions and suggestions covering all possibilities of response.
Many investigations (Bakan, 1969; Morgan, MacDonald, and Hilgard, 1974) have
explored the view that left-hemispheric functions are diminished during trance and then
assumed that right-hemispheric functioning was thereby enhanced. This does appear to be
the case in those specialized trance states where there are suggestions made to enhance
patients' perceptions of their own body and personality. The right hemisphere is more directly
concerned with the perception of sensory and kinesthetic cues, spatial orientation, and the
organization of the body schema (Luria, 1973). In the more typical trance state, however, it is
precisely the disturbances of the body schema that we recognize as characteristics of the
trance state. Distortions of the body image—such as feeling a part of the body (head, hand,
etc.) as being unusually large or small, dissociated, or anesthetic—are frequently commented
on spontaneously by subjects experiencing trance for the first time. Such distortions are also
characteristic of patients with organic disturbances of the right hemisphere. Luria reports
several other patterns of right-hemispheric dysfunction that are similar to spontaneous
phenomena of trance. Patients with deep lesions of the right hemisphere showed severe loss
of spatial orientation and disturbances of the time sense. As we have seen in this volume,
time distortion is highly characteristic of trance, and one of the most reliable signs of people
awakening from trance are their efforts to reorient to their own bodies. Luria even reports
"trance logic" in such patients wherein they firmly believe they can be in two places at once,
just as do some hypnotic subjects when they are experiencing visual hallucinations (Orne,
1959).
These correspondences indicate that in the typical trance right-hemispheric functions can
be depressed just as well as those of the left. In fact, because of the more global and diffuse
character of right-hemispheric functioning, the right hemisphere may be more easily altered
than the left. Because of this we frequently witness the disturbances of body schema, etc.
without any blocking of the more focal linguistic-logical functions of the left. This is particularly
characteristic of highly intellectualized subjects (Barber, 1975), who may accurately describe
the sensory-perceptual distortions their right hemisphere is experiencing with the unimpaired
verbal logic of the left hemisphere. Luria also comments on this situation, where patients will
make an effort to mask changes in personality and consciousness due to lesions of the right
hemisphere with glib verbal formulations. This sounds very similar to the mode of highly
intellectualized subjects, who tend to deny that trance or an altered state was experienced.
Such subjects are probably both right and wrong. They are right in denying any alteration in
their left-hemispheric functioning but are wrong in denying and remaining unaware of
alterations in their right-hemispheric functioning. This very denial of any disturbance in
functioning is also characteristic of patients with organic dysfunctions of the right hemisphere.
These considerations indicate that it may be too simple to view trance as a function of
the right hemisphere. The way trance is usually induced with suggestions for relaxation and
comfort tends to alter the functioning of both left and right hemispheres. We can understand
why right-hemispheric functions are usually more obviously altered than those of the left,
however. Since the left hemisphere is dominant and more focal in its functioning, the right
hemisphere tends to be depotentiated more easily in the early stages of learning to
experience trance. Most people have well-established habits to maintain and control their
left-hemispheric functions more than those of their right, so the right hemisphere tends to be
more easily depontentiated or altered than the left. And since the left hemisphere is the
center of verbal-logical consciousness, it can contradict or "defend" itself against the verbal-
logical suggestions of the hypnotherapist. The right hemisphere, by contrast, is used to
cooperating with the verbal-logical formulations of its own left hemisphere. The right
hemisphere thus need only generalize this function of cooperation to go along with the verbal
suggestions of the therapist.
These recent studies of the characteristics of left- and right-hemispheric functioning can
thus greatly enhance our understanding of trance phenomena. They provide a source of
interesting hypotheses for further explorations of trance experience and suggest means for
refining classical procedures as well as the invention of new methods. This
neuropsychological approach takes the verbal "magic" out of suggestions and provides us
with a sound rationale for understanding hypnotic susceptibility as a function of both genetic
and learned patterns of individual differences in behavioral response.
EIGHT

Infinite Patterns of Learning:


A Two-Year Followup
After one final session, during which Dr. S discussed her initial efforts and problems in
beginning to use hypnosis in clinical practice, Dr. S felt she had sufficient work with Erickson
for the present and planned to continue her training in the workshops of the American
Society of Clinical Hypnosis and under professional supervision where she worked.
Two years later she was contacted for a followup. She reported that in the intervening
period she had continued her training in hypnotherapy and was using it regularly in her
clinical practice. When she came for the actual interview, she sat in the same chair where
she had experienced her hypnotherapeutic training with Erickson. As she sat down and
adjusted herself, it was immediately obvious that she was taking her habitual posture for
induction, with her hands on her thighs, etc. Erickson recognized this body language and
without a word simply looked at her as he usually does when inducing hypnosis. By
reproducing the hypnotic situation in this way, Dr. S immediately went into a very deep
trance, deeper than any she had experienced previously.
The followup interview thus became another step, a very profound one, in Dr. S's
training. Erickson uses one of his own dream experiences to initiate a "two-stage dissociative
regression" wherein Dr. S experiences a genuine state of hyperamnesia and recovers
memories from a phase of her childhood that she had entirely forgotten. Erickson then
initiates a series of open-ended suggestions that would set Dr. S on an infinite path of inner
experiential learning. He successfully draws a curtain of amnesia over these suggestions so
that Dr. S's conscious mind cannot interfere with them. But the new experiential learning
would be available whenever Dr. S needed it.
Dr. S did manage to recall a bit of what her very deep experience was like in this session
before Erickson initiated the process of amnesia. She wrote a few revealing paragraphs,
"Reflections After Trance Induction," to describe her experience.
Of particular interest in this session is Erickson's illustration of the type of open-ended
suggestions that can give rise to infinite patterns of learning that can be of life-saving value.
He discusses the Pearson incident, where open-ended suggestions given to a student were
utilized by him years later in an emergency situation, where he was able to self-induce
anesthesia and an accelerated healing of the physical body after being hit on the head with a
brick.
The infinite possibilities of learning initiated by trance work were also illustrated by Dr. S's
ingenuous response to reading these transcripts two years after they occurred. She reported
that in these two years she had thought of herself as particularly inventive in her approaches
to initiating her patients into trance and the therapeutic uses she developed for trance in
groups as well as individuals. Upon reading these transcripts, however, she realized how
many of her "original" approaches had their origin in one thing or another that Erickson had
said or done here or there. Her trance experiences with Erickson had obviously interacted
with her own creative processes to originate new thinking and behavior patterns.

Body Language and Expectation of Trance


After being introduced to Dr. Z, who was present as an observer, the interview
proceeds as follows. S sits comfortably with her palms on her thighs, exactly as she
did two years ago when she was ready to enter trance. Erickson instantly recognizes
this readiness and without saying a word begins to look steadily and expectantly into
S's eyes.
S: You are staring at me again.
E: Describe your feelings as you sit there.
S: Oh, I feel fine. Relaxed and comfortable.
[Pause as E and S continue to look into each other's eyes. S then blinks slowly a few
times.]
E: Now I thought that was very interesting the way she sat down and began to sink
back into two years ago. All I did was give a look of confident expectation. Now that's
the important thing. An infant learning to walk, you know he can learn to walk, but the
infant doesn't know. You give the infant the confident support of your expectation.
R: Her body language cued you into the fact that she was ready for trance work. Your
expectant look silently acknowledged that readiness and permitted her to enter trance
without a word being said.

Ocular and Visual Alterations During Trance Induction:


Fogging Phenomenon and Trance Stare
S: It is getting foggy again.
(Pause)
Getting more
relaxed.
[Pause as the looking continued for a few moments longer until S finally closes her
eyes, takes a deeper breath, and quite obviously enters trance with a relaxation of
facial muscles and an absolute immobility of body.]
E: And now enjoy very much going deeper and deeper. (Pause)
R: She experiences this fogging even before she closes her eyes. It's her usual way of
experiencing the first stages of trance, just as she did two years ago. She also
demonstrates the "trance state" when she experiences this fogging. Her eyes have an
unblinking stare, a fixity of regard or a faraway or distant look. Weitzenhoffer (1971)
regards the trance stare as due to a decrease in the blink rate together with an
appreciable decrease in the spontaneous, random, saccadic movements of the eyeball.
Other subjects report all sorts of subjective changes in the visual field during trance
induction: alterations in the color background, tunnel vision, perceptual distortions,
illusions, blurring, an apparent decrease in illumination, a veil before the eyes, a
grayness over the visual field, and similar changes.

Deepening Trance
It is often said,
we learn to skate in the summer
and to swim in the winter.
We achieve certain
level of learning
to skate in the winter.
But the next winter
we start skating with a higher degree of excellence.
Because the random movements of skating
that complicated the first learning
have dropped out.
And the first winter
the random movements
were still fresh in mind.
(Pause)
Now you can go
much deeper
because
there are many fewer
random movements
or processes.
R: This was a new way of deepening trance after a long period of absence from
experiencing an induction. You simply describe a truism of the learning process:
random movements drop out during a period of rest. Therefore, this will be an even
deeper trance , than before.
E: And that is a past experience everyone has had.
R: So you've deepened trance by utilizing an innate learning process we all have
experienced.
E: You learn to write by grimacing your face and moving your feet, but after a while
these random and irrelevant movements drop out.

Open-Ended Suggestions
And now I don't know
what particular experiences
you want to sense.
I don't know if you have any conscious idea,
but always the unconscious mind has its own thoughts.
Its own desires.
(Pause)
And you can feel very pleased
in discovering
what your unconscious is going to do.
(Long pause)
And it will be your own experience.
(Pause)
And experience can be any place,
any time,
in any situation.
(Pause)
To look at one self
doing something
is always a charming thing.
(Pause)
I can give you a personal account.
In 1930,
in the early May,
I dreamed one night
that I was on the north side of an
east and west road.
in Wisconsin.
R: Here you begin a typical pattern of open-ended suggestions. You begin
depotentiating consciousness by saying that you , "don't know," and that implies that it
is okay if her conscious mind does not know either. But you emphasize that the
unconscious does have thoughts and desires, and you reinforce them by noting that
she can be pleases to discover what her unconscious is going to do. As her
"reflections" later indicate, she did use these open-ended suggestions in a manner that
was uniquely her own. You emphasize the open-ended aspect of your suggestion by
mentioning that it will be her experience any time, any place, any situation. This sounds
like a great deal of freedom. It is freedom as far as the conscious mind in concerned,
but it is being highly determined by her own unconscious.

Two-State Dissociative Regression


And I stood there
knowing that I was Dr. Erickson.
And I was looking at a small boy
who was running up and down.
By the grading on the side of the road by the hills
was a maintenance crew.
A fence on the top of the grade
and barbed wire fence.
Hazel bush,
an oak tree,
a wild cherry tree.
And I saw that barefoot boy with overalls
curiously probing the freshly graded ground,
and excavating around the cut ends of the roots,
and looking at the oak tree,
and looking at the wild cherry tree,
and then examining the cut ends of the roots,
trying to determine
which roots came from the wild cherry tree
and which came from the oak tree.
The little boy was sure
none of those roots came from hazelnut bush.
I approved of that boy.
I could see him plainly.
I recognized him
as little Milton Erickson.
R: This two-state dissociative regression wherein a person sees and sometimes even
relates to himself at an earlier age level was well described in your trance work with
Aldous Huxley (Erickson, 1965). You hoped to trip off this state in S by giving this
charming example of how it occurred to you in a dream state, where it is not
uncommon (Rossi, 1972, 1973a). As Dr. S remarks in her "reflections" on this session,
you did succeed at this point because she did see herself as a child reading a book by
Louisa May Alcott. She reports the actual recovery of memories from an entirely
forgotten phase of her life when she wanted to be a writer. That is, she experienced a
genuine hypermnesia!

Trance as an Atemporal Theater:


Active Imagination and Psychosynthesis
But he could not see Dr. Erickson.
He didn't even know I was on the other side of that east-
west-bound road.
And I enjoyed watching that little boy. And thinking
but how little appreciation he had of the fact that he was going to grow up and become
Dr. Erickson.
And then the dream terminated.
In September of that year
I did take a vacation trip to Wisconsin.
I went to the county seat,
got out all the records
of the county road maintenance work.
And I found out where that road was.
And then I drove to that area.
I found out how it was possible for
me to have been there.
There is a gravel pit near that road.
1 remember going there with my father when he got a load of gravel.
But I had no memory of ever examining that
fresh grading in the road.
But I found there was a hazelnut bush,
an oak tree,
and a wild cherry tree.
And I was still a little boy,
a barefoot boy.
I had long forgotten that,
but my unconscious mind
had remembered it.
(Pause)
R. It is utterly fascinating how in dreams and trance states the personality can
encounter itself at different age levels as if time did not exist. This was particularly clear
in your work with Huxley. These are states of active and creative imagination wherein
the person as an adult personality can actually relate to and help himself as a child. In
this way old traumas and needs, just about any form of "unfinished business," can be
resolved. This is a form of psychological healing that I believe is the essence of any
form of therapy, whether it takes place in dreams, trance, free association, active
imagination, meditation, or whatever. The common denominator is that something new
is synthesized within the personality (Rossi, 1973b).

Reading Minimal Body Movements in Trance:


Eye Movements in Trance
I'm suggesting this to you as a possible experience.
(Long pause)
I began work on the research service
in Worcester, Mass.
and was tremendously interested
in the thinking and behavior of people
at various levels.
And I knew I was going to Wisconsin on vacation in September.
And so my unconscious mind
furnished me with an opportunity
of observing myself
at a previous age.
(Pause)
And you work with patients
and you work with your understanding
and your understandings come
from your knowledge
of how you behave.
In your observations
of the behavior of others
(Pause)
you need
to have a vivid observation
of your own past behavior
(Long pause)
E: Now it is my interpretation that she was a bit abashed by Dr. Z's presence. But I
think Dr. Z isn't here now [for Dr. S]. As far as I can judge, there are quite a number of
mobile memories being manifested.
R: How can you tell?
E: By those muscle quiverings around that elbow. And the alterations of her breathing
are very suggestive of mobility. Sometimes those are suggestive of, for example, going
for a walk in the woods.
R: What is the meaning of those slight vibratory movements of the eyes?
E: Sometimes they are random movement, sometimes they signify a kind of
relaxation. You don't know really. I think a proper thing to do is let her discover bit by bit
more and more things about herself.
R: You like to have your patients discover and tell you about these minimal movements
rather than making spurious generalizations about them. This is very wise because
individual differences between people are so great in trance experience it is really
difficult to relate inner events to external behavior in any consistent way.
E: That's right.
R: Weitzenhoffer (1971) has investigated "slow eye movements of a pendular
(sinusoid) type resembling those which have been reported to accompany Stage I of
natural sleep and certain other altered states of consciousness. ... At such times the
subjects have been found to be still responsive to the hypnotist." Spiegel (1972) has
found eye-roll (the ability to look upward on signal while closing the eyelids) and squint
during induction to be indications of clinical hypnotizability. Other investigators (Switras,
1974; Wheeler et al., 1974), however, have found no relation between eye-roll and
other measures of hypnotic susceptibility in the laboratory. Ancient images as well as
modern photographs of yogi in meditation also show the upward roll of the eyeball.
Even though there are great individual differences in eye behavior during trance, it can
be studied for whatever clues it provides regarding altered states of consciousness.

Amnesia:
Protecting Trance Learning from Consciousness
Now it isn't important
for you
to recall
what you have achieved
here today.
Your unconscious can unfold it to you ,
in bits and parts
at the appropriate time,
and you will have a good understanding.
And anything not remembered today
is still recorded in your mind. (Pause)
R: In her later "reflections" Dr. S reported that this remark did in fact cause a dramatic
and unwanted amnesia.
E: I'm giving Dr. S an opportunity for inner experiential learning in this trance, which
she won't know about until the time is right to use it.
R: You don't want her to know about it till the time is right because you don't want her
conscious mind to interfere with it.
E: I don't want her conscious programs to depotentiate it!
R: So theoretically a patient could leave feeling you've done absolutely nothing for her?
E: That's right! And they often do!
R: Until later, when they call you up with reports of the value of what you've helped
them accomplish.
E: That's right.

Facilitating Potentialities:
Not Knowing and Open-Ended Suggestions for Infinite Learning:
Anesthesia and Body Healing
You need not know today
that perhaps you are anesthetized completely.
That you are immobilized completely.
(Pause)
You need not even know
if you have
dissociated yourself from your body.
At the right time you will discover
All the things that you have accomplished.
you will repeat these learnings
subsequently.
And you are beginning to realize
that you are a far better subject than you previously thought.
(Long pause)
And you keep right on in a trance,
learning the things you need to learn.
And I'm going to turn away from you and talk to Dr. R.
[Long pause during which Erickson quietly talks to Drs. Z and Rossi.]
E: In therapy this is often the way you get patients to become aware of their
capabilities. You are essentially giving them the freedom to use themselves. Patients
come to you because they don't feel free to use themselves.
R. Now is this the way you gave Dr. Robert Pearson open-ended suggestions for the
anesthesia that he was suddenly able to use in an emergency (Pearson, 1966)? You
say you had never given him specific suggestions to experience anesthesia.
E: No.
R: But he was able to develop an anesthesia that may well have saved his life because
years before you had given him such open-ended suggestions for the possibility of
anesthesia when he might need it.
E: I told him, "You know a lot of things you need to know, only you don't know you
know them. When the appropriate situation develops, use the appropriate learning."
R: Even though he had never experienced hypnotic anesthesia before, in an
appropriate situation, in the emergency situation when a brick hit him on the head, he
was able to develop a hypnotic anesthesia.
E: At that moment he said to himself, "If only Erickson were here." Erickson connoted
hypnosis for him, and that meant he should use hypnosis.
R: He should use hypnosis for his obvious need in that emergency situation. So this is
an extremely valuable suggestion you are giving to patients. You are stimulating in
them an infinite number of learnings that they will be able to apply at the appropriate
time.
E: That Pearson incident was a beautiful example of that. His associations to me were
primarily about hypnosis, anesthesia, and the utilization of the unconscious. He added
healing to that, better healing.
R: So he was able to effect faster body healing through hypnotic suggestion?
E: He was back lecturing in a few days with only a bandaid. His skull had been
fractured and chips of bone taken out. The surgeon had expected him to pad around in
his slippers for a few weeks.

Criteria for Trance Termination


[Erickson now studies Dr. S very intently for a few minutes.)
E: I don't know how to understand your finger movements,
the elbow movement,
the alteration in your breathing.
But comfortable,
slowly, agreeably,
bring your trance to an end
at a time of your own choice.
And come out of it feeling rested
and comfortable
and at ease,
with a sense of having done something very well.
R: What are you studying now?
E: I'm trying to determine how quickly I should awaken her.
R: What criteria are you using?
E: I don't know. I do know I won't do it now while she is taking a deep breath.
R: Why?
E: I don't know what is going on then. If you awaken a subject at the wrong moment,
they resent it. They can then demand that you put them back in trance so they can
finish.
R: How do you know when they are finished and ready to awaken?
E: You look for a quiet moment when all you can see is comfort.

Amnesia by Distraction
[Pause as Or. S reorients to her body, opens her eyes, and awakens. As soon as she
opens her eyes, before she is completely awakened, Erickson quickly distracts her.]
E: Did Dr. R ever tell you about my ironwood carvings?
S: Wha...?
E: Did Dr. R tell you about my ironwood carvings?
S; Ironwood carvings?
E: And yesterday I became the proud possessor of a frog riding a tricycle.
S: [laughs] Just what everybody needs, I guess.
[With laughter and mirth all around Erickson continues to talk about everything under
the sun except anything related to the session that has just taken place. We all then
join him to look at the ironwood carvings in the living room of his home.]
E: Now what I had to do was awaken her and distract her so whatever she has done
can remain at the unconscious level. I don't want it shoved into a conscious frame of
reference.
R: You produced an hypnotic amnesia by distraction (Erickson and Rossi, 1974), and
by this means you hoped to keep the trance work effective at an unconscious level. As
her later "Reflections" indicate, you were highly effective in facilitating this amnesia
even though she greatly regretted it. Some material did slip through to consciousness,
and this is the essence of her reflections.
REFLECTIONS AFTER TRANCE INDUCTION
by Dr. S
I first experienced fog and then trance, relaxed.
In response to Erickson's comments (roots, etc.) I remember various childhood memories
including a forgotten phase where I wanted to be a writer—I see myself reading a book by Louisa May
Alcott at the beach and planting a maple tree from seed which grew outside my bedroom window.
Scenes of walking on the beach, etc.
I think I must tell Dr. Erickson my wart is gone [Dr. S removed a wart on her own finger by self-
hypnosis] and that I have gotten to be a smoother therapist. Patients comment, "She helps you and it
doesn't hurt." I feel somewhat pleased.
I remember feeling my body numb and still.
I hear Dr. Erickson say something like "You won't have to remember what happens." Then,
suddenly, I look and my memories become fogged up. Then I see myself in a bed reflecting to myself,"
You are really going into a deep sleep— you will be so relaxed you won't remember your dream."
I can't remember anything after that. But have a feeling I was in a dream-phantasy trance for
some time. I wake up after a suggestion (that's the first thing I can recall) relaxed, serene, satisfied
and great!
Apart from her interesting comments on fogging, the recovered memories from a
forgotten identity phase of childhood (wanting to be a writer, the numbness of her body, and
her apparent psychosomatic healing in removing a wart through self-hypnosis, Dr. S's
description of how she experiences her amnesia is particularly revealing. She reports that
Erickson's words are transformed in her mind into a visual image of herself in bed "really
going into a deep sleep—you will be so relaxed you won't remember your dream."
Erickson maintains that all successful suggestion contains this process of transformation
whereby the therapist's words are reformulated in a manner that is consistent with the
personal psychodynamics of the subject. Thus it is very important to facilitate this
transformation process with permissive suggestions that are formulated in as open-ended a
manner as possible. Erickson frequently reinforces this tendency by directly suggesting that
the patient's unconscious can hear and transform the therapist's words in any way that would
be most suitable for its own functioning.

INFINITE POSSIBILITIES OF CREATIVITY, HEALING, AND


LEARNING
The depotentiation of a subject's limited and habitual frames of reference together with
open-ended suggestions to facilitate new possibilities of creativity, healing, and learning
appears to be one of the most exciting prospects opened by Erickson for a hypnotherapy of
the future. His life work has demonstrated the possibilities of utilizing trance as an inner-
directed experience wherein one can get free from some of the learned limitations of
previous history and training. The mind is an incredibly vast reservoir whose potentials are
still unrealized by most people. Trance is a free period for the inner discovery, exploration,
and realization of these potentials. At the present time we see only the tip of the iceberg of
the possibilities of human nature. Hypnosis has been greatly hampered by its past image of
being a technique for manipulation and control. How boring to deal with manipulation and
control when we can be facilitating new possibilities of human nature undreamed of by either
therapist or patient. Like dream, reverie, and creative states of imagination, trance can be a
period for free development. The art of the modern hypnotherapist is in opening up the
possibility of this development by helping each individual outgrow his own learned limitations.
NINE

Summary
Our approach in this volume has been to make a detailed analysis of the actual words
and approaches of one outstanding clinician in the area of hypnotherapy. Our object has
been to learn as much as possible about Erickson's approaches so that other clinicians and
research workers could study, test, and utilize our findings. Because Erickson's approaches
presuppose a certain amount of clinical skill, a major goal of this volume has been to
carefully delineate exactly how Erickson goes about his work, the observations and
inferences he makes, and the hypotheses he tests. Any fair evaluation of his approaches
requires that the clinician and researcher acquire some of Erickson's hypnotherapeutic skills.
To facilitate this process of skill acquisition, we have outlined the types of study and
exercises that other workers might well pursue to further their clinical practice and research
in hypnosis.
To help the reader organize the material of this volume we will summarize some of its
basic ideas under four major headings:
1. The Nature of Therapeutic Trance
2. Clinical Approaches to Hypnotic Induction
3. The Forms of Hypnotic Suggestion
4. The Facilitation of Human Potentials

I. THE NATURE OF THERAPEUTIC TRANCE


Erickson tends to be atheoretical and pragmatic in his approach. His knowledge comes
from practical experience about what works rather than theoretical speculation. He has never
formulated an overall theory of hypnosis, and it is only with some prompting that he will
express himself on theoretical issues. The following views about therapeutic trance are
definitely expressed throughout this volume, however.

a. Trance Viewed as Inner Directed States


Trance phenomena may be understood in the broadest sense as inner-directed states
wherein the multiple foci of attention so characteristic of our usual everyday consciousness
are restricted to relatively few inner realities. Because of this restricted focus, new learning
can proceed more sensitively and intensely in trance when the patient is not interrupted by
irrelevant stimuli and the limitations of his usual frames of reference.

b. Trance Viewed as a Highly Motivated State


Erickson carefully notes and utilizes a patient's personal psychodynamics and motivation
for initiating and developing trance experience. It is patients' motivation that will bind them to
their task of inner focus. It is this uniquely personal motivation that may account for some of
the differences found between laboratory hypnosis (where standardized methods are used
that tend to exclude the subject's individuality) and clinical hypnosis (where the patient's
individuality is of essence in the approaches used for trance induction and utilization).

c. Trance Viewed as Active Unconscious Learning


Fundamental to Erickson's approach is his view that patients have problems because of
their learned limitations. The object of trance is to relax these learned limitations of the
patient's usual frames of reference to permit the vast reservoir of their unrecognized
potentialities to operate. Freed from the common sets, biases, and inhibitions of
consciousness, learning can proceed on an autonomous or what is conventionally called an
unconscious level. In the ideal case Erickson first clears the mental stage from the clutter of a
patient's learned limitations and then helps patients utilize their own unique life experience
and associations to create and restructure themselves from within on an unconscious level
without the mediation of consciously directed thinking. Trance is thus an active process of
unconscious learning somewhat akin to the process of latent learning or learning without
awareness described in experimental psychology (Deese and Hulse, 1967). This is different,
indeed, from the crude conception of hypnosis as a passive and regressed state where the
patient is an automaton under the control of the operator.

d. Trance Viewed as an Altered State of Functioning


The research literature of the past decade has dealt extensively with the contrasting
views of trance as an altered state versus the view of trance as simply a motivated situation
wherein the subject follows the operator's instructions as well as possible. The difficulty in
resolving this controversy is in a definition of what constitutes an "altered state" and the
development of objective measures of the "altered state." In a recent paper on hypnotic
amnesia (Erickson and Rossi, 1974) the authors have made a case for the "state theory" of
clinical hypnosis as follows.
Researchers (Fisher, 1971) have recently investigated state-dependent learning in a
number of ways. One group of subjects memorize nonsense syllables while drunk. It is then
found that they are better able to recall them on a later occasion when they are drunk than
when they are sober. Recall is thus state-dependent; recall takes place better when people
are in the same state they were in when exposed to the learning. Other investigators verified
the same state-dependent phenomenon with amphetamine-induced excitatory states and
amobarbitual-induced inhibitory states. Fisher generalizes these results into a theory of "how
multiple existence became possible by living from waking state to another waking state; from
one dream to the next; from LSD to LSD; from one creative, artistic, religious or psychotic
inspiration or possession to another; from trance to trance; and from reverie to reverie."
We would submit that therapeutic trance itself can be most usefully conceptualized as
but one vivid example of the fundamental nature of all phenomenological experience as
"state-bound." The apparent continuity of consciousness that exists in everyday normal
awareness is in fact a precarious illusion that is only made possible by the associative
connections that exist between related bits of conversation, task orientation, and so on. We
have all experienced the instant amnesias that occur when we go too far on some tangent so
we "lose the thread of thought" or "forget just what we were going to do." Without the bridging
associative connections, consciousness would break down into a series of discrete states
with as little contiguity as is apparent in our dream life.
It is now a question of definition and of further empirical work to determine whether these
states are discrete and different in mental content alone or whether more gross physiological
indicators can be used in defining them. A drug obviously introduces a physiological change
that may or may not be measurable with current techniques. With therapeutic trance the case
is more equivocal. The case is further complicated by the fact, as Fisher indicates above, that
once an altered state is produced, "symbolic" associations alone are sufficient to reinduce it.
How can we reconcile this special-state theory of hypnotic trance with the many
informative experimental studies that support the alternative paradigm (Barber, 1969) of
hypnosis as a "responsive waking state" that is not discontinuous or essentially different from
normal ordinary consciousness? In many of his papers Erickson (1939, 1952, 1966a) has
emphasized that deep or really satisfactory trance experience depends on the ability to
subordinate and eliminate waking patterns of behavior; that is, to give up some of the learned
limitations and habitual frameworks of one's characteristic conscious attitudes. To achieve this
end Erickson evolved many new techniques of induction and stressed the need for careful
"hypnotic training" whereby the individuality of each subject was carefully taken into account to
maximize the presence of involuntary or autonomous behavior in trance with as little participation
of habitual conscious attitudes and mental frameworks as possible. In his early work Erickson
rarely gave therapeutic suggestions until the trance had developed for at least 20 minutes—and
this only after hours of previous hypnotic training. After years of experience his clinical evaluation
of the patient's psychodynamics and current mental state enabled him to work much more rapidly.
In actual practice it is admittedly difficult if not impossible to eliminate all waking patterns.
This is particularly true in the typical experimental study, where standardized instructions and
direct suggestions are utilized with little or no extensive hypnotic training directed to the
elimination or at least the mitigation of habitual conscious patterns in trance. The presence of
many verbal, sensory, perceptual, and psychodynamic associations common to both the
trance and waking situation in most experimental studies bridges the gap between them and
further reduces their discontinuity. We would therefore submit that the alternative paradigm,
which views the trance and waking conditions as more or less continuous, with no evidence
of a "special state of trance," is correct in evaluating the typical experimental situation. It does
not, however, adequately conceptualize those clinical situations where the skill of the
therapist together with the needs of the patient interact to produce the striking discontinuities
between trance and the normal state of consciousness that are so suggestive of special-state
theory.
This issue is analogous to the heated controversy about the fundamental nature of light
as continuous (waves) or discontinuous (particles) that plagued physicists during the first
quarter of this century. In practice it has been found helpful to think of light sometimes as
waves and other times as particles. The most adequate conceptualization, however, is
through mathematical symbols that cannot be meaningfully related to in terms of everyday
associations on the verbal and imagery level. Likewise in clinical practice it may be most
helpful to conceptualize and stress those antecedent and mediating variables that promote
discontinuity between trance and waking state, while in experimental work there may be
more theoretical interest in dealing with the continuities.

e. The Subjective Experience of Trance


The subjective experience of trance naturally varies as a function of an individual's
personality and life history (Hilgard, 1970) as well as of the approach used for trance
induction and utilization. One common denominator in the experience of most of Erickson's
patients is that in trance things seem to happen by themselves. As was so well demonstrated
with the experiential learning of trance phenomena by Dr. S, there is a sense of surprise
when a hand levitates or an ideosensory phenomenon is manifest.
The contrast between what happens by itself and what we seem to control and direct is
in fact one of the most profoundly interesting things about the subjective experience of mind.
Our mental life is a dialogue between what happens to us and what we do about it.
Sensations, perceptions, emotions, moods, dreams, fantasies and associations are always
happening spontaneously on an unconscious level and presenting themselves to the
threshold of consciousness. How we learn to respond to these spontaneous presentations
determines in great part our sense of reality, mental health, and well-being. We can respond,
for example, to the new that occurs to us in perceptions or in dreams with, on the one hand,
fright, flight, and phobia or with curiosity and creativity on the other hand (Rossi, 1972a).
From our earlier statement of trance as a process of unconscious learning it would follow
that trance deals primarily with those autonomous processes that make presentations to
consciousness. But things are not that simple. In most experiences of trance some observer
ego is present, quietly taking in the scene; the patient is quietly watching what is happening
within (Gill and Brenman, 1959). It is this observing ego that gives a detached, impersonal
and objective quality to much of the conscious ideation in trance. The objective quality of this
ideation makes it particularly useful in psychotherapy. As long as this observer ego is
present, however, many patients will insist they are not hypnotized; they equate the observer
function with being conscious in the normal sense of the word.
Erickson is always concerned about this observer function, and many of his approaches
are designed to jostle it about and depotentiate it. Not that consciousness itself is a problem
in trance, but rather its associated functions of directing and controlling are the problem. In
trance the ego alters its habitual patterns of control and direction, while varying degrees of
the observer function remains intact. This permits two things to happen:
1. The autonomous (unconscious) presentations (everything from sensations and
emotions to dreams and spontaneous associations) are freed to function spontaneously
without the restrictions of the ego's usual frames of reference.
2. The interface between these autonomous presentations and the observing ego can be
broadened so that, in effect, more of the unconscious can become conscious.
Erickson's preference is for therapy to proceed by the first process alone. He is always
delighted when the patient solves his problem without knowing how he did it.
The more conventional forms of depth psychotherapy proceed by the second process of
making more of the unconscious conscious. Erickson has used this process as one step in
some of his overall plans of hypnotherapy (Erickson, 1954, 1955).

2. CLINICAL APPROACHES TO HYPNOTIC INDUCTION

a. Orientation to Hypnotic Induction


The purpose of trance induction is threefold.
1. to reduce the foci of attention (usually to a few inner realities).
2. to facilitate alterations in the subject's habitual patterns of direction and control.
3. to facilitate patients' receptivity to their own inner associations and mental skills that
can be integrated into therapeutic responses.
Ordinarily this is very simply accomplished by Erickson when he tells a patient to sit in a
certain way, focus on a spot, and remain quiet while Erickson talks. Erickson then embarks
on a train of associations that will help the patient focus attention inward on memories,
feelings, and all sorts of associations, developmental patterns, and learning experiences. In
this Erickson is not so much suggesting (in the sense of putting something into the patient's
mind) as he is evoking. The effectiveness of his words is in their calculated design to evoke
preexisting patterns of association and natural mental processes in the patient. He can evoke
memories because the memories are already there in the person. He can evoke amnesia,
anesthesia, or any other hypnotic phenomenon only because there are built in mechanisms
for these processes already existing in the patient.
Erickson watches patients very carefully during induction. Induction is certainly not a
standardized and mechanical procedure where he parrots some formula by rote. Erickson
carefully notes where patients are all the time. The precise moment he chooses to begin an
induction might be when he senses that patients need to focus inward and alter some limiting
aspect of their conscious attitude and belief system so that therapy can proceed. Erickson
understands trance as a normal experience of everyday life that occurs naturally whenever a
person becomes deeply absorbed in some inner or outer reality (e.g., daydreaming or
listening to music). Erickson notes the beginning signs of trance and then simply reinforces
them in any way that is particularly appropriate for a particular person in the here and now
circumstances.
Erickson has commented that he can recognize potentially good subjects in an audience
by noting those who seem "frozen" (relatively little body movement) and those who exhibit
"response attentiveness" (those who become very absorbed in what another is saying or
doing). The moment when these characteristics are manifest in the therapy session is
obviously the best time for trance induction. If they do not become manifest naturally,
Erickson might initiate them by focusing and fixating the patient's attention with an interesting
story, anecdote, or whatever is motivating and absorbing for that particular patient. These
interesting stories may seem irrelevant to the casual observer, but through them Erickson is
actually initiating a "yes set" and following behavior by the patient that will gradually lead into
the induction phase proper.
Erickson has described the state of response attentiveness as the common "everyday
trance," and he frequently utilizes this natural form of absorption just as he would trance.
Even without any form of formal trance induction, patients will become so absorbed in what
he is saying that they later wonder if Erickson had somehow, without their knowledge, put
them in trance. "Suggestions" made while the patient is in this state of absorption can be just
as effective as when in formal trance. Trance thus need not be formally induced for effective
clinical work. The approaches to clinical induction described in this volume are simply a
convenient means by which the therapist can initiate a process of inner focus and
unconscious learning.

b. Approaches to Hypnotic Induction


It is well that we speak of "approaches" to hypnotic induction rather than "methods" or
"techniques." These latter words have connotations of being mechanical, hard-and-fast
procedures that one imposes on a person. Erickson imposes nothing. He simply tries to
evoke the natural process within patients that will enable them to be receptive to their own
inner realities and experience the possibility of new creative inner work being done to resolve
a problem.
Erickson has developed a bewildering variety of "approaches" to these ends. As was
illustrated in this volume he will frequently use a variety of these approaches in the same
session. With each approach he learns something new about the patient's characteristic
ways of responding. He accepts whatever response the patient makes as adequate. How
could it be other than adequate since it is an expression of the patient's individuality? It is in
this individuality that a unique solution will be found for his unique problem. These responses
teach Erickson something about the patient's individual ways of responding (the patient's
"behavior hierarchy"), and he uses this knowledge as a kind of feedback that allows him to
modify his approaches to further fit the individuality of patients to help them achieve the inner
direction and receptiveness that are so characteristic of trance.
We can in summary list some of the particular and general approaches to trance
induction that are illustrated in this volume. All of these approaches can be used for either
direct or indirect induction of trance, depending on how they are presented to the patient.
Particular Approaches General Approaches
Early learning set Conversational
Eye fixation Confusion
Hand levitation Pantomime
Handshake induction Conditioning
Mutual trance induction Experiential
Posthypnotic cue Introspection-imagination
Evoking previous trance associations Surprise
Rhythm induction Question
Shift in frames of reference
Heightened-awareness
Most of these approaches can be described as more or less indirect because
consciousness is not entirely aware of exactly what is happening. Consciousness
understands something of what is happening but not all. Things soon seem to begin
happening all by themselves, conscious sets are further depotentiated, and trance begins.
We have described the microdynamics of trance induction and suggestion with a number of
flow diagrams that could be summarized as follows:
Fixation of attention via The amazing, unusual, standard
approaches to hypnotic induction or anything
that attracts and holds the subject's attention.
Depotentiating conscious sets via Shock, surprise, distraction, dissociation, and
other hypnotic forms.
Unconscious search via Implication, questions, analogy, and other
indirect hypnotic forms.
Unconscious processes via Summation of literal and personal associations
and mental mechanisms structured by all the
above.
Hypnotic response via Expression of behavioral potentials experienced
as taking place all by themselves.

c. Depotentiating Habitual Frames of Reference


When we state that the purpose of clinical induction is to focus patients inward and help
them alter the controlling and directing functions of their habitual attitudes and belief system,
we are in effect helping them depotentiate their usual everyday consciousness. Because of
the limitations of their habitual frames of reference, their usual everyday consciousness
cannot cope with certain inner and/or outer realities, and they recognize he has a "problem."
Depotentiating patients' usual everyday consciousness is thus a way of depotentiating their
personal limitations. Depotentiating the limitations of an individual's usual patterns of
awareness thus opens up the possibility that new combinations of associations and mental
skills may be evolved for creative problem solving within that individual.
So subtle and pervasive are Erickson's approaches to depotentiating conscious sets that
they have taken a significant place in most of our commentaries. They have also been listed
as a major topic in most of our essays concerned with the description and dynamics of
Erickson's hypnotic forms. Here we can only list some of the hypnotic forms that can be
utilized to depotentiate a subject's habitual frame of reference.
Absence of challenge Dissociation
Casual and permissive manner Double bind
Amnesias structured continually Doubt
Boredom Expectancy and need for closure
Confusion Involuntary signaling
Continually redirecting attention Losing abilities
Contradictions Negations
Displacing doubt and discharging resistance Using therapist's rhythm
Partial remarks and dangling phrases Voice locus and emphasis
Questions that distract Yes set
Rest You don't need to know
Tasks outside patient's usual frames of
reference

d. Indicators of Trance Development


Once induction has begun, Erickson recognizes a variety of indications of developing
and deepening trance such as the following. Trance experience is highly individualized,
however, and patients will manifest these indicators in varying combinations as well as in
different degrees.
Autonomous ideation Objective and impersonal ideation
Balanced tonicity (catalepsy) Pupillary changes
Changed voice quality Response attentiveness
Comfort, relaxation Sensory, muscular, and body changes
Economy of movement Slowing and loss of blink reflex
Eye changes and closure Slowing pulse
Facial features ironed out Slowing respiration
Feeling distant Spontaneous hypnotic phenomena
Feeling good after trance Amnesia
Lack of body movement Regression
Lack of startle response Anesthesia
Literalism Catalepsy
Retardation of reflexes Time distortion
swallowing etc.
blinking Time lag in motor and conceptual behavior
As these indications become manifest (usually over a period of 10 to 20 minutes),
Erickson gradually introduces verbalizations designed to evoke recognizable responses from
patients to indicate that they are in rapport and are following Erickson. These can vary from
head nodding or shaking to hand levitation and, bit by bit, other hypnotic phenomena that are
useful for training that particular patient in trance work so he can eventually accomplish his
therapeutic goals.
It is of interest to note that Erickson looks for the spontaneous development of such
hypnotic phenomena as age regression, anesthesia and catalepsy as more genuine
indicators of trance than when these same phenomena are "suggested." When they are
directly suggested, we run into the difficulties imposed by the patient's conscious attitudes
and sets. When they come about spontaneously, they are the natural result of the
dissociation or the loosening of ego control over the general reality orientation that is
characteristic of trance.
Certain investigators have selected some of these spontaneous phenomena as defining
characteristics of the fundamental nature of trance. Shor (1959) and Meares (1957), for
example, have taken regression as a fundamental aspect of trance. From our point of view,
however, regression per se is not a fundamental characteristic of trance, although it is often
present as an epiphenomenon of the early stage of trance development, when the patient is
learning to give up ego control. In this first stage of giving up ego control many uncontrolled
things happen, including spontaneous age regression, paresthesias, anesthesias, illusions of
body distortion, psycho-somatic responses, time distortion, and others. Once patients have
learned to stabilize these unwanted side reactions, they can then allow their unconscious to
function freely in interacting with the therapist's suggestions without the mediation of their
conscious ego.

e. Ratifying Trance
Since the observer function of the ego is usually more or less present in trance, the
patient will sometimes refuse to believe he was in trance, and this belief can limit further
work. Because of this it is necessary to demonstrate that trance is in fact different from the
ordinary awake state! Erickson describes this as "ratifying the trance." The most convincing
ratification of trance is the therapist's astuteness in recognizing and pointing out the
spontaneous hypnotic phenomena that are becoming manifest so the patient can recognize
that he is involved in an altered or unusual state. All of the above-mentioned general
indications of trance development are well suited for this purpose as well as any individual
patterns a particular patient may manifest. In addition Erickson utilizes the spontaneous body
reorientation on awakening as well as alterations in pulse and respiration as evidence of
trance. In his experiential approach to trance he will have patients explore all the differences
in their sensory, motor, and conceptual behavior between the trance and awake state.
Erickson frequently asks questions that involve a double bind to ratify trance. Any answer
that is given to the question, "You really think you are awake, don't you?" tends to ratify
trance by implication. Another such double bind question is, "Do you know if you were in a
trance?" This question appears to ask for simple information, but either a "yes" or "no"
answer ratifies trance ("yes" means trance with awareness; "no" implies trance without
awareness). He regularly asks new patients what time it is as soon as they emerge from
trance to ratify their trance by the spontaneous time distortion that is usually involved.
Questions are always a particularly useful approach to ratifying trance because they elicit
behavioral evidence from the patient's personal experience. This is vastly more convincing
than any therapist's authoritative statements about the patient's state.
In awakening a new subject from trance by counting backward from 20 to one, Erickson
will sometimes use the surprised reversal technique whereby he suddenly reverses the count
(20, 19, 18 ... 12, 11, 10, 11, 12, 13 ... 20) so the subjects experience a "jerk" or mild vertigo
as they suddenly feel themselves going back into trance as the numbers shift from
backwards (awakening) to forward (deepening).
Erickson maintains that formal ritualistic techniques are not needed to induce trance. Any
conversation that is really absorbing can entrance people without them necessarily
recognizing their own trance state. In such cases Erickson believes they are listening and
capable of thinking and responding on the conscious and unconscious levels simultaneously.
How does one ratify the fact that a trance is being experienced when a person evidences a
high degree of response attentiveness? Simple! Erickson just asks for an autonomous
response from the unconscious with a question such as, "If you have been in trance, your
unconscious will let your right hand lift." Or, "If your unconscious thinks you've been in a
trance, your eyelids will grow heavy and close." Obviously, not all investigators will agree
with Erickson's approach and with his interpretation that affirmative autonomous responses
to such questions are valid indicators that a trance existed. The subjects could be responding
in a way that they believe Erickson wants them to. More clinical experience and controlled
laboratory studies will be needed to settle such issues.
As we have repeatedly witnessed in the demonstrations of this volume, Erickson will use
a buckshot approach in evoking many possibilities of posthypnotic suggestion. When any
posthypnotic suggestion is then carried out, of course, it ratifies trance in a most convincing
way. Probably Erickson's favorite approach to ratifying trance is to induce an arm catalepsy
and then awaken the subject with the arm still cataleptic. The peculiarity of observing one's
arm in an awkward position ratifies trance in a particularly vivid way. Throughout this volume
the reader will note how carefully Erickson develops, supports, and then ratifies all of his
suggestions as each hypnotic phenomenon becomes manifest. Trance and hypnotic
phenomena are delicate, ephemeral, and evanescent in their appearance, particularly in the
first stages of trance training. It is therefore necessary to strongly reinforce and ratify them
when they do become manifest.

3. THE FORMS OF HYPNOTIC SUGGESTION

a. The Nature of Hypnotic Suggestion


Complex and multifaceted as they may seem, Erickson's approaches to suggestion have
but one rationale: suggestions are designed to bypass the patient's erroneously limited belief
system; suggestions must circumvent the all too narrow limits of ordinary everyday
consciousness.
It has been estimated that most of us do not utilize more than 10 percent of our mental
capacity. Erickson certainly believes this. Our consciousness usually has too narrow, rigid,
and limited a conception of what it is capable of accomplishing. Ordinary education and daily
life have taught us how to accomplish some things but have unwittingly biased us against
many if not most of our capacities.
We all know from everyday experience that we can be so absorbed in something that
interests us that we ignore everything else. We can "not hear" someone calling us and we
can "not feel" pangs of hunger. Yet if you baldly ask someone to "not hear" or "not feel," they
will look at you in disbelief. Our normal consciousness does not know how to "not hear" or
"not feel" on direct command, even though the mental apparatus can do these things easily
and automatically when the everyday conditions of ordinary life are suitable.
Erickson's indirect forms of suggestion are all means of arranging such suitable
conditions so that individuals can accomplish things that are within their behavioral repertory
but usually not available to voluntary control (although automatically and unconsciously
available when the ordinary circumstances of life call for them, as illustrated above). The
wonder and fascination of hypnosis is that it enables us to control these responses that are
usually mediated by unconscious mechanisms outside the normal range of consciousness.
The art and science of the hypnotherapist is in knowing enough about behavior and learning
in general, and the individual experiences of each patient in particular, so the therapist can
present suggestions to evoke all the responses necessary to accomplish a given therapeutic
goal.
The theory is simple, but the practice is difficult until the therapist has really learned how
to evoke responses that are usually outside the patient's normal range of ego control. There
are vast individual differences to be taken into account. Some patients can easily accept
direct suggestions simply because they believe so much in the therapist's "prestige" or
"power." Such belief wipes away the limitations and doubts characteristic of their usual
attitudes; they don't believe they can accomplish such and such by themselves, but their
belief system allows them to accomplish it in the special circumstances of therapy.
Other patients, more critical and doubting, caught in a narrow, rationalistic view of
themselves, require indirect suggestions that will bypass the destructive limitations of their
belief system. Still other patients, more in tune with the facts, recognize their personal
limitations but need not believe in the prestige or power of the therapist; rather, they hope the
therapist really has the skill to help them accomplish their goal by indirect suggestions whose
rationale they need not understand at the time. It is in the invention and practice of indirect
suggestion for the average or "resistant" ("limited" would be a better word) patient that
Erickson has excelled. We will now make an effort to catalog those indirect approaches to
suggestion.

b. Indirect Approaches to Hypnotic Suggestion


Wetterstrand (1902), who was one of Bernheim's foremost students, described the
problem of suggestion in a manner that places Erickson's indirect approaches in proper
historical perspective.
Suggestion, or rather suggestibility, is composed of two elements: ability to receive an impulse from
without, and the ideo-plastic faculty. [The power that ideas possess to influence physiological
conditions.] As these are absolutely independent of each other, we must distinguish between them.
There are patients who are very impressionable, and who accept a suggested idea with absolute
confidence; the influence, however, of the idea upon their physiological functions is feeble. They do
not realize the suggestions, and their morbid symptoms yield with great difficulty, as their ideo-plastic
conception is small. Others, on the contrary, accept suggestions slowly, are incredulous and even
resist them. Nevertheless we find that the physiological and pathological processes are easily modified
by the psychic influence, sometimes by autosuggestions.
In keeping with this dichotomy, Erickson's indirect approaches may be divided into two
similar categories:
1. Structuring an acceptance set to facilitate the acceptance of the "suggested idea."
2. Utilizing the patient's associative processes and mental skills to facilitate the "ideo-
plastic faculty."
1. Structuring an Acceptance Set. Every therapist has innumerable approaches for
facilitating an atmosphere of cooperation, receptivity, and the possibility of creativity within
the therapy session. Here we will only list the hypnotic forms that we have found in prominent
use by Erickson in the actual process of trance induction and the facilitation of hypnotic
responses. The index is keyed to illustrations and discussions of all of these hypnotic forms
for facilitating an acceptance set.
The "yes set"

Truisms and tautologies

Use of interesting and personally motivating material

Intercontextual cues and suggestions


Interspersal technique

Obtaining patient's assent

Casual, permissive, and positive approach

Vocal intonations of sincerity and intentness

Validating and ratifying suggestions

Covering all possibilities of response

Accepting all responses as valid

Building expectancy
2. Utilizing the Patient's Associative Structure and Mental Skills. Erickson's work is rich in
hypnotic forms designed to utilize a patient's own associative structure and mental processes
to facilitate the "ideo-plastic faculty."
Not all of these hypnotic forms are original with Erickson. The evocation of hypnotic
phenomena by asking pointed questions, for example, is a classical approach much utilized
by Braid (1846) to evoke hallucinatory phenomena in all sense modalities even while patients
were apparently awake. The invention and systematic use of a variety of these hypnotic
forms for the study and utilization of a patient's own associative structure and mental skills in
ways that are outside his usual range of conscious ego control to effect therapeutic goals,
however, does appear to be one of Erickson's original contributions to the theory and
practice of "suggestion." The use of these hypnotic forms is by now so much a part of
Erickson's nature that Rossi sometimes felt "woozy" and a bit in a trance even while
apparently having a straightforward intellectual discussion with Erickson. Erickson himself is
not always clear about the means by which his "conversation" is effective in structuring and
directing a listener's associative processes in predetermined ways. Erickson maintains that
fixing and focusing attention by such conversation does put the listener into trance without
the need for any other formal process of induction. As we have repeatedly seen in this volume,
a single sentence uttered by Erickson can be loaded with a number of hypnotic forms that catch
the listener's mental fabric in various ways. In this volume it has been our precarious task to make
a beginning in untangling, uncovering, and labeling some of these indirect hypnotic forms, which
are listed below:
Apposition of opposites Multiple tasks and serial suggestions
Binds and double binds Not doing, not knowing
Compound suggestions Open-ended suggestions
Contingent suggestions Pantomime and nonverbal suggestions
Covering all possibilities of a class of Paradoxical intention
responses Partial remarks and dangling phrases
Dissociation Questions
Ideomotor signaling Surprise
Implication Truisms
Implied directive Utilizing need for closure
Intercontextual cues and suggestions Voice locus and dynamics
Multiple levels of communication (analogy, Yes set
puns, metaphor, etc.)
These hypnotic forms are all merely descriptive labels of different aspects of suggestion;
they need not function independently of one another. One and the same suggestion, for
example, could be a truism (because it is true), a compound suggestion (because it contains
at least two connected statements), and an implication (because it implies that more than
one may be immediately apparent). In fact, the art of formulating suggestions is to utilize as
many of these mutually reinforcing hypnotic forms as possible in close proximity.
It is important to repeat that while Erickson does think of trance as a special state, he
does not believe hypersuggestibility is a necessary characteristic of trance. That is, just
because patients experience trance, it does not mean they are going to accept the therapist's
suggestions. This is a major misconception that has frustrated and discouraged many
workers in the past and has impeded the development of hypnosis as a science. Trance is a
special state that intensifies the therapeutic relationship and focuses patients' attention on
inner realities. Trance does not ensure the acceptance of suggestions. Erickson depends on
the above approaches to evoke and move patients' associative processes and mental skills
in certain directions to sometimes achieve certain goals. So-called suggestion is actually this
process of evoking and utilizing a patient's own associations, mental skills, and mental
mechanisms.
How shall we conceptualize the hypnotic forms listed above? Obviously, they are
communication devices of sorts. They are all bits and pieces of the new science of
pragmatics: the relation between signs and the users of signs. Since these communication
devices have all been developed in clinical practice, there is an urgent need to validate them
and study their parameters in controlled laboratory studies as well as in further clinical and
field experiments. There appears to be an infinite expanse of exploration awaiting future
workers in this area. Undoubtedly the field will continue to expand and change just as human
consciousness itself develops in new ways.

THE FACILITATION OF HUMAN POTENTIALS


Throughout this volume we have touched upon the various means by which human
potentials and unrealized abilities may be explored and facilitated during trance. Trance in
this sense can be understood as a period of free exploration and learning unencumbered by
some of the limitations of a person's previous history. It is for this purpose that Erickson
developed so many unique approaches to hypnotic induction and trance training wherein a
person's usual limitations could be altered momentarily so that inner potentials could become
manifest. The great variety of these approaches can never become standardized because
happy humans are never static and standardized. Everyone is an individual in a process of
development. The hypnotic interaction reflects and facilitates this development in ways that
are creative and surprising to both therapists and patients. Well-trained hypnotherapists are,
above all, fine observers who are able to recognize the fetters that bind human nature. They
are ever eager to make available means of freeing and facilitating human development. They
then wisely stand aside to watch and wonder about its ultimate course.
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